Organization
ARIZONA STATE UNIVERSITY
Active
Parent organization
ARIZONA STATE UNIVERSITY
Other names
ASU Health Services Downtown NP Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARIZONA STATE UNIVERSITY
Authorized official
DIANE L PERRY RNP (DIRECTOR)
(602) 496-0665
Entity
Organization
Contact information
Practice address
500 N 3RD ST, SUITE 155, PHOENIX, AZ 85004-2135
(602) 496-0721
(602) 496-0675
Mailing address
500 N 3RD ST, SUITE 155, PHOENIX, AZ 85004-2135
(602) 496-0721
(602) 496-0675
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207841
—
AZ
01
—
Z21383
MEDICARE PTAN
AZ
Enumeration date
01/02/2007
Last updated
05/15/2013
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