Healthcare Provider Details

I. General information

NPI: 1568078657
Provider Name (Legal Business Name): VHS OUTPATIENT CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2020
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE 1800
GLENDALE AZ
85308-1372
US

IV. Provider business mailing address

6320 W UNION HILLS DR STE 1800
GLENDALE AZ
85308-1372
US

V. Phone/Fax

Practice location:
  • Phone: 623-242-1231
  • Fax: 623-242-1232
Mailing address:
  • Phone: 623-242-1231
  • Fax: 623-242-1232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BRIAN RASMUS
Title or Position: VP, CFO TPR
Credential:
Phone: 469-893-2532