Provider Demographics
NPI:1952007106
Name:PALO VERDE HEMATOLOGY AND ONCOLOGY LTD
Entity Type:Organization
Organization Name:PALO VERDE HEMATOLOGY AND ONCOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-941-1211
Mailing Address - Street 1:13802 W MEEKER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375
Mailing Address - Country:US
Mailing Address - Phone:623-547-2600
Mailing Address - Fax:
Practice Address - Street 1:19636 N 27TH AVE
Practice Address - Street 2:#202
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027
Practice Address - Country:US
Practice Address - Phone:623-257-9344
Practice Address - Fax:623-257-9368
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALO VERDE HEMATOLOGY ONCOLOGY LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site