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Organization

MOUNTAIN PARK HEALTH CENTER

Active
Parent organization
MOUNTAIN PARK HEALTH CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
MOUNTAIN PARK HEALTH CENTER
Authorized official
DR. JOHN R SWAGERT M.D. (CEO)
(602) 323-3242
Entity
Organization

Contact information

Practice address
635 E. BASELINE RD., PHOENIX, AZ 85042-6551
(602) 243-7277
(602) 243-1235
Mailing address
3003 N CENTRAL AVE STE 1600, PHOENIX, AZ 85012-2908
(602) 323-3242
(602) 323-3496

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
OTC 0599
AZ
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC0599
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
FQ31810
AZ
Enumeration date
06/02/2006
Last updated
03/13/2018
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