MEDICARE: VHS ARIZONA HEART INSTITUTE INC

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
1	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1497060966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VHS ARIZONA HEART INSTITUTE INC

Provider Business Mailing Address
First Line	:	20 BURTON HILLS BLVD
Second Line	:	ATTN: CAROL BAILEY
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6197
Country	:	US
Telephone Number	:	615-665-6000
Fax Number	:	615-665-6184

Provider Business Practice Location Address
First Line	:	708 S. COEUR D'ALENE DRIVE
Second Line	:	SUITE B, LOWER LEVEL
City	:	PAYSON
State	:	AZ
Zip	:	85541-5662
Country	:	US
Telephone Number	:	928-474-2175
Fax Number	:	928-474-9424

Authorized Official
Title or Position	:	CFO
Name	:	SHALEN YOUNG
Credential	:
Telephone Number	:	623-561-7728

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	03/24/2022

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