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General NPI Number Information
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NPI Number | 1134190093
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Entity Type | Organization
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Legal Business Name | MAYO CLINIC ARIZONA
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5404
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Country | US
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Telephone | 480-301-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 13400 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5404
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Country | US
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Telephone | 480-301-8000
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | ROSHANAK DIDEHBAN
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Credential |
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Telephone | 480-301-6493
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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 | 2856
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 2856
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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