Healthcare Provider Details

I. General information

NPI: 1821033044
Provider Name (Legal Business Name): MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 W HATCHER RD
PHOENIX AZ
85021-3139
US

IV. Provider business mailing address

934 W HATCHER RD
PHOENIX AZ
85021-3139
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-6342
  • Fax: 602-344-6306
Mailing address:
  • Phone: 602-344-6342
  • Fax: 602-344-6306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberY004190
License Number StateAZ

VIII. Authorized Official

Name: ANNA SOGARD
Title or Position: DIRECTOR OF PHARMACY
Credential:
Phone: 602-344-5253