Healthcare Provider Details

I. General information

NPI: 1669870937
Provider Name (Legal Business Name): VHS OF PHOENIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2014
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W BETHANY HOME RD
PHOENIX AZ
85015-2443
US

IV. Provider business mailing address

1445 ROSS AVE SUITE 1400
DALLAS TX
75202-2711
US

V. Phone/Fax

Practice location:
  • Phone: 602-249-0212
  • Fax: 602-246-5849
Mailing address:
  • Phone: 469-893-2200
  • Fax: 469-893-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KELSIE BLACKWELL
Title or Position: CFO
Credential:
Phone: 602-246-5922