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NPI Code Detail

MEDICARE: MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT

MEDICARE: MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care HospitalH3673AZ
2261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114346962
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Provider Business Mailing Address
First Line : PO BOX 29670
Second Line :
City : PHOENIX
State : AZ
Zip : 85038-9670
Country : US
Telephone Number : 602-344-8180
Fax Number : 602-344-8122
Provider Business Practice Location Address
First Line : 2025 W NORTHERN AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-5157
Country : US
Telephone Number : 602-655-6300
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF REIMBURSEMENT
Name : PAMELA S FOWLER
Credential :
Telephone Number : 602-344-2830
Provider Enumeration Date : 04/09/2014
Last Update Date : 04/26/2023

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Directions to “MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT ” Practice Location

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