Provider Demographics
NPI:1205172467
Name:ARIZONA CENTER FOR HEMATOLOGY AND ONCOLOGY PLC
Entity type:Organization
Organization Name:ARIZONA CENTER FOR HEMATOLOGY AND ONCOLOGY PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-949-7808
Mailing Address - Street 1:5750 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE C300
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4660
Mailing Address - Country:US
Mailing Address - Phone:480-949-7808
Mailing Address - Fax:480-946-4850
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5648
Practice Address - Country:US
Practice Address - Phone:480-949-7808
Practice Address - Fax:480-946-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0908090002Medicare NSC