Healthcare Provider Details

I. General information

NPI: 1760686653
Provider Name (Legal Business Name): CATHOLIC HEALTHCARE WEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W THOMAS RD SUITE 108
PHOENIX AZ
85013-4419
US

IV. Provider business mailing address

222 W THOMAS RD SUITE 108
PHOENIX AZ
85013-4419
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3970
  • Fax: 602-406-7145
Mailing address:
  • Phone: 602-406-3970
  • Fax: 602-406-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3471
License Number StateAZ

VIII. Authorized Official

Name: LINDA HUNT
Title or Position: PRESIDENT
Credential:
Phone: 602-406-6001