Organization
PHOENIX CHILDREN'S MEDICAL GROUP
Active
Parent organization
PHOENIX CHILDREN'S HOSPITAL, INC.
Other names
Phoenix Children's Ambulatory Specialty Center - Avondale
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX CHILDREN'S HOSPITAL, INC.
Authorized official
RAHEEL FAROUGH (SVP, MANAGED CARE & PAYER STRATEGY)
(602) 933-3548
Entity
Organization
Contact information
Practice address
1665 N AVONDALE BLVD, AVONDALE, AZ 85392-5003
(602) 933-0005
(602) 933-2478
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
SH3107
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876253
—
AZ
Enumeration date
02/14/2013
Last updated
05/22/2023
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