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NPI Code Detail

MEDICARE: ARIZONA SPINE AND JOINT HOSPITAL LLC

MEDICARE: ARIZONA SPINE AND JOINT HOSPITAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care HospitalSH3711AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396745832
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA SPINE AND JOINT HOSPITAL LLC
Provider Business Mailing Address
First Line : 4620 E BASELINE RD
Second Line :
City : MESA
State : AZ
Zip : 85206-4624
Country : US
Telephone Number : 480-824-1226
Fax Number : 480-824-1269
Provider Business Practice Location Address
First Line : 4620 E. BASELINE ROAD
Second Line :
City : MESA
State : AZ
Zip : 85206
Country : US
Telephone Number : 480-824-1226
Fax Number : 480-824-1269
Authorized Official
Title or Position : OFFICER/AUTHORIZED OFFICIAL
Name : MR. ERIC BOON
Credential :
Telephone Number : 480-567-0269
Provider Enumeration Date : 07/27/2005
Last Update Date : 05/06/2026

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