Provider Demographics
NPI:1942336243
Name:THE VHS ARIZONA IMAGING CENTERS, LP
Entity Type:Organization
Organization Name:THE VHS ARIZONA IMAGING CENTERS, LP
Other - Org Name:TMC ADVANCED IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-674-6524
Mailing Address - Street 1:PO BOX 975258
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-0001
Mailing Address - Country:US
Mailing Address - Phone:602-674-6524
Mailing Address - Fax:602-674-6773
Practice Address - Street 1:8620 N 22ND AVE
Practice Address - Street 2:STE. 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4251
Practice Address - Country:US
Practice Address - Phone:602-674-6524
Practice Address - Fax:602-674-6773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1942287693OtherNPI
AZ1730166539OtherNPI
AZ1740267590OtherNPI
AZ1912984634OtherNPI
AZAZ0889470OtherBLUE CROSS BLUE SHIELD ID
AZ574948Medicaid
AZ1Z7035OtherHEALTHNET ID
AZ1821075631OtherNPI
AZF06217OtherPHOENIX HEALTH PLAN
AZ1942287693OtherNPI
AZ470001392Medicare ID - Type UnspecifiedMEDICARE RAILROAD
AZ1740267590OtherNPI
AZZ66941Medicare PIN
AZ1821075631OtherNPI
AZZ66937Medicare PIN