Provider Demographics
NPI:1205883162
Name:SOUTHWEST CARDIOVASCULAR ASSOCIATES AHMED ALFAFARA AND PRASAD LTD
Entity type:Organization
Organization Name:SOUTHWEST CARDIOVASCULAR ASSOCIATES AHMED ALFAFARA AND PRASAD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-758-4114
Mailing Address - Street 1:1648 HWY 95
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442
Mailing Address - Country:US
Mailing Address - Phone:928-758-4114
Mailing Address - Fax:928-758-4650
Practice Address - Street 1:1648 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7906
Practice Address - Country:US
Practice Address - Phone:928-758-4114
Practice Address - Fax:928-758-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24429ZMedicare PIN
AZZ177348Medicare PIN
NVV37051Medicare PIN