Provider Demographics
NPI:1780763243
Name:AINSWORTH CONSULTING GROUP LLC
Entity type:Organization
Organization Name:AINSWORTH CONSULTING GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:AINSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-792-0352
Mailing Address - Street 1:2175 N ALMA SCHOOL ROAD
Mailing Address - Street 2:SUITE C104
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2879
Mailing Address - Country:US
Mailing Address - Phone:480-222-6770
Mailing Address - Fax:480-222-6771
Practice Address - Street 1:2175 N ALMA SCHOOL ROAD
Practice Address - Street 2:SUITE C104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2879
Practice Address - Country:US
Practice Address - Phone:480-222-6770
Practice Address - Fax:480-222-6771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF15836OtherPHOENIX HEALTH PLAN ID
AZ630467Medicaid
AZ447171Medicaid
AZ2Z4296OtherHEALTHNET IDENTIFIER
AZ726672Medicaid