Organization
MOLLEN IMMUNIZATION CLINICS II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ROBINSON (CHIEF FINANCIAL OFFICER)
(480) 214-2000
Entity
Organization
Contact information
Practice address
8324 E. HARTFORD DRIVE, SCOTTSDALE, AZ 85255
(480) 214-2000
(480) 718-8358
Mailing address
8324 E. HARTFORD DRIVE, SCOTTSDALE, AZ 85255
(480) 214-2000
(480) 718-8358
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHC 066
MEDICARE PTAN
—
Enumeration date
05/09/2008
Last updated
08/30/2013
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