Organization
LOS NINOS HOSPITAL INC.
Active
Other names
Los Ninos Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DALE NORMAN SKURDAHL (CHIEF OPERATING OFFICER-M.S.)
(602) 243-4231
Entity
Organization
Contact information
Practice address
2303 E. THOMAS RD, PHOENIX, AZ 85016
(902) 954-7311
(902) 954-7355
Mailing address
1402 E. SOUTH MOUNTAIN AVENUE, PHOENIX, AZ 85042
(602) 243-4231
(602) 323-5988
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
SHO188
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D0898997
CLIA WAIVER
AZ
05
—
155128
—
AZ
01
—
SHO188
STATE LICENSE
AZ
Enumeration date
10/07/2006
Last updated
08/22/2020
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