Organization
PHOENIX PERFUSION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MACHELLE A SHOOK (DIRECTOR OF OPERATIONS)
(480) 248-3070
Entity
Organization
Contact information
Practice address
1830 S ALMA SCHOOL RD, SUITE 108, MESA, AZ 85210-3056
(480) 248-3070
(480) 248-3099
Mailing address
1830 S ALMA SCHOOL RD, SUITE 108, MESA, AZ 85210-3056
(480) 248-3070
(480) 248-3099
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126922
HEALTHNET
AZ
01
—
AZ0725920
BCBS OF AZ
AZ
Enumeration date
02/13/2007
Last updated
05/17/2012
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