Provider Demographics
NPI:1952395444
Name:ARIZONA FAMILY CARE PLLC
Entity Type:Organization
Organization Name:ARIZONA FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-773-2848
Mailing Address - Street 1:PO BOX 11447
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-1447
Mailing Address - Country:US
Mailing Address - Phone:623-773-2848
Mailing Address - Fax:623-773-0370
Practice Address - Street 1:18555 N 79TH AVE
Practice Address - Street 2:B-108
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-773-2848
Practice Address - Fax:623-773-0370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ103956Medicare ID - Type UnspecifiedBONNIE MC DONALD DO
AZZ74706Medicare PIN
AZI34085Medicare UPIN
AZH83334Medicare UPIN
AZZ74705Medicare PIN
AZG61012Medicare UPIN
AZZ74707Medicare PIN