Healthcare Provider Details

I. General information

NPI: 1083606057
Provider Name (Legal Business Name): CIGNA HEALTH CARE OF ARIZONA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6811 E SUPERSTITION SPRINGS BLVD
MESA AZ
85209-4001
US

IV. Provider business mailing address

8888 E RAINTREE DR STE 300
SCOTTSDALE AZ
85260-3968
US

V. Phone/Fax

Practice location:
  • Phone: 480-641-4050
  • Fax: 480-641-4011
Mailing address:
  • Phone: 602-328-8400
  • Fax: 623-877-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2565
License Number StateAZ

VIII. Authorized Official

Name: RICH KORB JR.
Title or Position: STAFF PHARMACIST, SR. MANAGER
Credential: PHARMD, BCACP
Phone: 480-769-2513