Provider Demographics
NPI:1700910189
Name:DIGNITY COMMUNITY CARE
Entity Type:Organization
Organization Name:DIGNITY COMMUNITY CARE
Other - Org Name:CHANDLER REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-728-3144
Mailing Address - Street 1:475 S DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5605
Mailing Address - Country:US
Mailing Address - Phone:480-963-4561
Mailing Address - Fax:480-728-3875
Practice Address - Street 1:475 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5605
Practice Address - Country:US
Practice Address - Phone:480-963-4561
Practice Address - Fax:480-728-3875
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY COMMUNITY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-15
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 2994261QU0200X
AZOTC 1528261QU0200X
AZH3002282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
6140115OtherAETNA
AZ5663439OtherAETNA FACILITY
AZ500498Medicaid
AZ721561132852240000OtherTRICARE
AZAZ0208860OtherBLUE CROSS BLUE SHIELD
AZAZ0208830OtherBLUE CROSS BLUE SHIELD
AZAZ0208850OtherBLUE CROSS BLUE SHIELD
AZF00160Medicaid
AZIZ0610OtherHEALTHNET FACILITY ID
AZ72156113285048A001OtherTRICARE
AZ500498001Medicaid
AZ5457625OtherAETNA FACILITY
AZ721561132OtherIRS
AZ72156113285224A001OtherTRICARE
AZAZ0208850OtherBLUE CROSS BLUE SHIELD
AZAZ0208830OtherBLUE CROSS BLUE SHIELD
AZAZ0208860OtherBLUE CROSS BLUE SHIELD
AZ5663439OtherAETNA FACILITY