Organization
SOUTHWEST NETWORK, INC.
Active
Other names
Southwest Network
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY B. HENNING (CHIEF EXECUTIVE OFFICER)
(602) 285-4340
Entity
Organization
Contact information
Practice address
2311 W ROYAL PALM RD, PHOENIX, AZ 85021-4916
(602) 269-5300
(602) 269-5380
Mailing address
2700 N CENTRAL AVE, SUITE 1050, PHOENIX, AZ 85004-1133
(602) 266-8402
(602) 264-0887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
OTC6787
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC6787
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378698
—
AZ
01
—
Z127516
MEDICARE PTAN
AZ
Enumeration date
10/02/2008
Last updated
02/18/2025
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