Provider Demographics
NPI:1922532944
Name:DISPATCHHEALTH-ARIZONA
Entity Type:Organization
Organization Name:DISPATCHHEALTH-ARIZONA
Other - Org Name:DISPATCHHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AO/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-589-4149
Mailing Address - Street 1:3825 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3316
Mailing Address - Country:US
Mailing Address - Phone:303-500-1518
Mailing Address - Fax:720-598-0440
Practice Address - Street 1:4602 E UNIVERSITY DR STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7423
Practice Address - Country:US
Practice Address - Phone:520-442-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty