Organization
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Active
Other names
Dialysis Center at Valleywise Comprehensive Care Center - Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KIRKLAND (PFS DIRECTOR)
(602) 344-8178
Entity
Organization
Contact information
Practice address
2525 E ROOSEVELT ST, PHOENIX, AZ 85008-4948
(602) 344-8180
Mailing address
PO BOX 29670, PHOENIX, AZ 85038-9670
(602) 344-8180
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
H3673
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189350800
US DEPT OF LABOR
AZ
01
—
29517
PHOENIX INDIAN MEDICAL CENTER
AZ
01
—
500005
EVERCARE CHOICE
AZ
01
—
631935
AETNA
AZ
05
—
987487
—
AZ
01
—
AZ0205850
BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0947
HEALTHNET OF AZ
AZ
Enumeration date
03/26/2014
Last updated
05/04/2020
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