MEDICARE: VHS OUTPATIENT CLINICS, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1679429211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VHS OUTPATIENT CLINICS, INC.

Provider Business Mailing Address
First Line	:	1840 S STAPLEY DR STE 137
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6683
Country	:	US
Telephone Number	:	480-558-3744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 S STAPLEY DR STE 137
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6683
Country	:	US
Telephone Number	:	480-558-3744
Fax Number	:

Authorized Official
Title or Position	:	VP, CFO TPR
Name	:	BRIAN RASMUS
Credential	:
Telephone Number	:	469-893-2532

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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