Provider Demographics
NPI:1851478333
Name:SUSAN ALBRIGHT PLC
Entity Type:Organization
Organization Name:SUSAN ALBRIGHT PLC
Other - Org Name:OPTUM PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-480-2550
Mailing Address - Street 1:203 S CANDY LN
Mailing Address - Street 2:SUITE 13A
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4120
Mailing Address - Country:US
Mailing Address - Phone:928-649-1389
Mailing Address - Fax:928-634-5314
Practice Address - Street 1:203 S CANDY LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4120
Practice Address - Country:US
Practice Address - Phone:928-649-1389
Practice Address - Fax:928-634-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1154354306OtherINDIVIDUAL NPI NUMBER
AZP77768Medicare UPIN
AZ111782Medicare PIN