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General NPI Number Information
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NPI Number | 1831896778
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Entity Type | Organization
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Legal Business Name | HONORHEALTH-FASTMED AMBULATORY HOLDINGS, LLC
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 24874 N 67TH AVE
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City | PEORIA
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State | AZ
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Zip | 85383-4245
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Country | US
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Telephone | 602-598-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 W UTOPIA RD
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City | PHOENIX
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State | AZ
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Zip | 85027-4171
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Country | US
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Telephone | 480-587-5314
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Fax |
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Authorized Official
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Title or Position | EVP/CPI
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Name | JOHN MICHAEL NEIL
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Credential |
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Telephone | 804-587-5123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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