Provider Demographics
NPI:1790005668
Name:NEXTCARE ARIZONA LLC
Entity Type:Organization
Organization Name:NEXTCARE ARIZONA LLC
Other - Org Name:NEXTCARE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUFELDT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:480-924-8382
Mailing Address - Street 1:2550 N THUNDERBIRD CIR
Mailing Address - Street 2:ST. 303
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1215
Mailing Address - Country:US
Mailing Address - Phone:480-924-8382
Mailing Address - Fax:
Practice Address - Street 1:7425 E SHEA BLVD
Practice Address - Street 2:STE. 108
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6411
Practice Address - Country:US
Practice Address - Phone:800-819-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC3317261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care