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General NPI Number Information
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NPI Number | 1629060686
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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 | 01/26/2015
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Provider Practice Location Address
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Address Line | 16635 N 43RD AVE
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City | PHOENIX
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State | AZ
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Zip | 85053-2707
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Country | US
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Telephone | 602-843-7933
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Fax | 602-843-7946
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Provider Business Mailing Address
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Address Line | 25500 N NORTERRA DR
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City | PHOENIX
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State | AZ
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Zip | 85085-8200
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Country | US
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Telephone | 623-277-1168
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Fax | 623-277-1023
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Authorized Official
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Title or Position | PHARMACY OPERATIONS MANAGER
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Name | ERIC LUECHT
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Credential |
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Telephone | 623-277-1168
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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 | 1640
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License Number State | AZ
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