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General NPI Number Information
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NPI Number | 1528050572
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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 | 10/31/2024
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Provider Practice Location Address
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Address Line | 1300 N 12TH ST STE 404
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City | PHOENIX
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State | AZ
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Zip | 85006-2866
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Country | US
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Telephone | 602-282-9880
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Fax | 602-282-9879
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1501
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License Number State | AZ
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