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General NPI Number Information
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NPI Number | 1083606057
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Entity Type | Organization
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Legal Business Name | CIGNA HEALTH CARE OF ARIZONA INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 6811 E SUPERSTITION SPRINGS BLVD
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City | MESA
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State | AZ
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Zip | 85209-4001
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Country | US
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Telephone | 480-641-4050
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Fax | 480-641-4011
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Provider Business Mailing Address
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Address Line | 8888 E RAINTREE DR STE 300
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3968
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Country | US
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Telephone | 602-328-8400
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Fax | 623-877-1091
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Authorized Official
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Title or Position | STAFF PHARMACIST, SR. MANAGER
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Name | RICH KORB JR.
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Credential | PHARMD, BCACP
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Telephone | 480-769-2513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2565
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License Number State | AZ
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