Provider Demographics
NPI:1790872901
Name:SCOTTSDALE HEALTHCARE HOSPITALS
Entity Type:Organization
Organization Name:SCOTTSDALE HEALTHCARE HOSPITALS
Other - Org Name:TINA'S TREASURES
Other - Org Type:Other Name
Authorized Official - Title/Position:SR. VICE PRESIDENT & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPORTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-882-4502
Mailing Address - Street 1:3501 N SCOTTSDALE RD SUITE 136
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:480-882-6050
Mailing Address - Fax:
Practice Address - Street 1:3501 N SCOTTSDALE RD SUITE 136
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:480-882-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ918870335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ918870OtherSTATE LICENSE TAX
AZ0720280005Medicare NSC