Provider Demographics
NPI:1740479260
Name:MAGELLAN HEALTH SERVICES
Entity type:Organization
Organization Name:MAGELLAN HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMARAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-994-5211
Mailing Address - Street 1:6330 E THOMAS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6330 E THOMAS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7057
Practice Address - Country:US
Practice Address - Phone:480-994-5211
Practice Address - Fax:480-994-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10930302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization