Healthcare Provider Details

I. General information

NPI: 1114798071
Provider Name (Legal Business Name): NEXTCARE ARIZONA I JV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 N SCOTTSDALE RD STE 104
TEMPE AZ
85288-2116
US

IV. Provider business mailing address

2145 E BASELINE RD STE 101
TEMPE AZ
85283-1546
US

V. Phone/Fax

Practice location:
  • Phone: 480-924-8382
  • Fax: 480-924-8382
Mailing address:
  • Phone: 888-705-8558
  • Fax: 480-776-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRIS M KANE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 888-705-8558