Provider Demographics
NPI:1023122843
Name:CARDIOJOST, PLLC
Entity type:Organization
Organization Name:CARDIOJOST, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MT
Authorized Official - Last Name:JOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-945-4343
Mailing Address - Street 1:7529 E BROADWAY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-2007
Mailing Address - Country:US
Mailing Address - Phone:480-945-4343
Mailing Address - Fax:480-945-4350
Practice Address - Street 1:7529 E BROADWAY RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-2007
Practice Address - Country:US
Practice Address - Phone:480-945-4343
Practice Address - Fax:480-945-4350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X
AZ28064207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No3336C0002XSuppliersPharmacyClinic PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ492794Medicaid
AZ1134121874OtherCHARLES JOST, MD
AZZ108829Medicare PIN
AZ1134121874OtherCHARLES JOST, MD