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NPI Code Detail

MEDICARE: CIGNA HEALTH CARE OF ARIZONA INC

MEDICARE: CIGNA HEALTH CARE OF ARIZONA 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
1333600000XPharmacy1640AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11988688OTHERPK

General Provider Information

NPI Number : 1629060686
Entity Type Code : Organization
Provider Name (Legal Business Name) : CIGNA HEALTH CARE OF ARIZONA INC
Provider Business Mailing Address
First Line : 25500 N NORTERRA DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85085-8200
Country : US
Telephone Number : 623-277-1168
Fax Number : 623-277-1023
Provider Business Practice Location Address
First Line : 16635 N 43RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85053-2707
Country : US
Telephone Number : 602-843-7933
Fax Number : 602-843-7946
Authorized Official
Title or Position : PHARMACY OPERATIONS MANAGER
Name : ERIC LUECHT
Credential :
Telephone Number : 623-277-1168
Provider Enumeration Date : 08/16/2005
Last Update Date : 01/26/2015

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Directions to “CIGNA HEALTH CARE OF ARIZONA INC ” Practice Location

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