Organization
PHOENIX CHILDREN'S MEDICAL GROUP
Active
Parent organization
PHOENIX CHILDREN'S HOSPITAL, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX CHILDREN'S HOSPITAL, INC.
Authorized official
RAHEEL FAROUGH (SVP, MANAGED CARE & PAYER STRATEGY)
(602) 933-3548
Entity
Organization
Contact information
Practice address
5131 E SOUTHERN AVE, MESA, AZ 85206-2799
(602) 933-0002
(602) 933-6216
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
SH3107
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876253
—
AZ
Enumeration date
06/13/2008
Last updated
05/22/2023
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