Healthcare Provider Details

I. General information

NPI: 1942644158
Provider Name (Legal Business Name): UNITED HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 N CENTRAL AVE
PHOENIX AZ
85012-2902
US

IV. Provider business mailing address

4881 N BUCKMEISTER WAY
MARANA AZ
85653-8292
US

V. Phone/Fax

Practice location:
  • Phone: 602-345-2486
  • Fax:
Mailing address:
  • Phone: 602-345-2486
  • Fax: 602-345-2487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberAP4916
License Number StateAZ

VIII. Authorized Official

Name: MS. PATRICIA LUPE ARROYO
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP
Phone: 520-401-8917