Provider Demographics
NPI:1801204490
Name:MD BUSINESS SOLUTIONS CORP
Entity Type:Organization
Organization Name:MD BUSINESS SOLUTIONS CORP
Other - Org Name:TEMPE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:PROF
Authorized Official - First Name:ARNOLDO
Authorized Official - Middle Name:PROCELA
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:III
Authorized Official - Credentials:MS, JD
Authorized Official - Phone:520-400-8660
Mailing Address - Street 1:441 S 48TH ST
Mailing Address - Street 2:109, ARNOLDO LOPEZ
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2303
Mailing Address - Country:US
Mailing Address - Phone:480-945-2558
Mailing Address - Fax:480-945-2354
Practice Address - Street 1:441 S 48TH ST
Practice Address - Street 2:109, ARNOLDO LOPEZ
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2303
Practice Address - Country:US
Practice Address - Phone:480-945-2558
Practice Address - Fax:480-945-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-26
Last Update Date:2014-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12985302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP0731420OtherBLUE CROSS
AZ196768Medicaid
AZ196768Medicaid
AZZ73761Medicare PIN
AZC45892Medicare UPIN