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General NPI Number Information
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NPI Number | 1811359417
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Entity Type | Organization
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Legal Business Name | CALLED TO CARE MEDICAL CENTER
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 1806 N 114TH AVE
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City | AVONDALE
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State | AZ
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Zip | 85392-5235
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Country | US
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Telephone | 602-885-7535
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Fax | 602-865-8295
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Provider Business Mailing Address
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Address Line | PO BOX 1633
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City | AVONDALE
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State | AZ
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Zip | 85323-0540
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Country | US
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Telephone | 602-885-7535
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Fax | 602-865-8295
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Authorized Official
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Title or Position | CEO
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Name | MR. OSAGINWEN KINGSLEY AYIYI
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Credential | FNP
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Telephone | 602-885-7535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AP8375
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License Number State | AZ
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