Organization
MARICOPA COUNTY D.B.A. MARICOPA COUNTY DEPART
Active
Parent organization
MARICOPA COUNTYD.B.A. MARICOPA COUNTY DEPARTMENT OF HEALTH
Other names
Clinical Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARICOPA COUNTYD.B.A. MARICOPA COUNTY DEPARTMENT OF HEALTH
Authorized official
MR. MAX PORTER (DEPUTY DIRECTOR)
(602) 506-6641
Entity
Organization
Contact information
Practice address
1645 E. ROOSEVELT STREET, CLINICAL SERVICES, PHOENIX, AZ 85006
(608) 506-6660
(602) 375-0342
Mailing address
1645 E ROOSEVELT STREET, CLINICAL SERVICES, PHOENIX, AZ 85006
(602) 506-6660
(602) 372-0342
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OTC3761
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097451
—
AZ
Enumeration date
06/17/2008
Last updated
02/08/2012
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