Healthcare Provider Details

I. General information

NPI: 1700279379
Provider Name (Legal Business Name): ARROWHEAD HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16222 N 59TH AVE
GLENDALE AZ
85306-1701
US

IV. Provider business mailing address

13430 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85254-4058
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax:
Mailing address:
  • Phone: 623-334-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberAS9056
License Number StateAZ

VIII. Authorized Official

Name: DR. JANICE JOHNSTON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 623-451-3782