Organization
PHOENIX CHILDREN'S HOSPITAL
Active
Other names
Phoenix Children's Hospital Specialty Clinic Mercy Gilbert
Organization subpart
No
Provider details
NPI number
Authorized official
RAHEEL FAROUGH (VP, MANAGED CARE)
(602) 933-3548
Entity
Organization
Contact information
Practice address
3420 S MERCY RD, STE 121, GILBERT, AZ 85297-0419
(602) 933-6262
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-7761
(602) 933-1815
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
SH3107
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
706707
—
AZ
05
—
876253
—
AZ
Enumeration date
09/10/2014
Last updated
04/21/2022
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