Provider Demographics
NPI:1184731804
Name:STATE OF ARIZONA STATE DEPT OF FINANCE
Entity type:Organization
Organization Name:STATE OF ARIZONA STATE DEPT OF FINANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:RODNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CGFM
Authorized Official - Phone:602-220-6372
Mailing Address - Street 1:2500 E VAN BUREN ST
Mailing Address - Street 2:ATTN: FINANCE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6037
Mailing Address - Country:US
Mailing Address - Phone:602-220-6000
Mailing Address - Fax:
Practice Address - Street 1:2500 E VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6037
Practice Address - Country:US
Practice Address - Phone:602-220-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
029331OtherAHCCCS- MEDICAID
AZ034021Medicare Oscar/Certification