Provider Demographics
NPI:1831383603
Name:ARIZONA ON CALL HEALTH
Entity type:Organization
Organization Name:ARIZONA ON CALL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-456-5022
Mailing Address - Street 1:2426 W KIOWA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6380
Mailing Address - Country:US
Mailing Address - Phone:480-456-5022
Mailing Address - Fax:480-820-7339
Practice Address - Street 1:2426 W KIOWA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6380
Practice Address - Country:US
Practice Address - Phone:480-456-5022
Practice Address - Fax:480-820-7339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARG99475Medicare UPIN