Provider Demographics
NPI:1871035360
Name:MEDI-FIRST MEDICAL CENTER P.L.L.C.
Entity Type:Organization
Organization Name:MEDI-FIRST MEDICAL CENTER P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:XUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-279-2400
Mailing Address - Street 1:727 E BETHANY HOME RD
Mailing Address - Street 2:A-101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2198
Mailing Address - Country:US
Mailing Address - Phone:602-279-2400
Mailing Address - Fax:602-279-5890
Practice Address - Street 1:727 E BETHANY HOME RD
Practice Address - Street 2:SUITE A-101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2198
Practice Address - Country:US
Practice Address - Phone:602-279-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ378625Medicaid
AZ378625Medicaid