Provider Demographics
NPI:1669886149
Name:THE ARIZONA PARTNERSHIP FOR IMMUNIZATION
Entity type:Organization
Organization Name:THE ARIZONA PARTNERSHIP FOR IMMUNIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCUNE DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-288-7566
Mailing Address - Street 1:700 E JEFFERSON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2201
Mailing Address - Country:US
Mailing Address - Phone:602-218-3902
Mailing Address - Fax:602-218-3901
Practice Address - Street 1:700 E JEFFERSON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2201
Practice Address - Country:US
Practice Address - Phone:602-218-3902
Practice Address - Fax:602-218-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ498839Medicaid