Healthcare Provider Details

I. General information

NPI: 1568384071
Provider Name (Legal Business Name): PHOENIX CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 E THOMAS RD AMBULATORY BUILDING
PHOENIX AZ
85016
US

IV. Provider business mailing address

1919 E THOMAS RD AMBULATORY BUILDING
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 833-312-0036
  • Fax: 602-933-2057
Mailing address:
  • Phone: 833-312-0036
  • Fax: 602-933-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: RAHEEL M FAROUGH
Title or Position: MANAGED CARE AND PAYOR STRATEGY
Credential: SVP
Phone: 602-933-3548