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General NPI Number Information
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NPI Number | 1255110474
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Entity Type | Organization
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Legal Business Name | PHOENICIAN MEDICAL CENTER, INC
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Dates
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Enumeration Date | 09/26/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 13943 N 91ST AVE BLDG E
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City | PEORIA
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State | AZ
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Zip | 85381-3629
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Country | US
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Telephone | 480-963-1953
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Fax | 480-963-1854
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Provider Business Mailing Address
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Address Line | 1343 N ALMA SCHOOL RD STE 160
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City | CHANDLER
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State | AZ
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Zip | 85224-5901
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Country | US
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Telephone | 480-963-1853
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Fax | 480-963-1854
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Authorized Official
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Title or Position | COO
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Name | ANUPAM AHLAWAT
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Credential |
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Telephone | 480-444-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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