Organization
PHOENIX CHILDREN'S MEDICAL GROUP
Active
Parent organization
PHOENIX CHILDREN'S HOSPITAL, INC.
Other names
Phoenix Children's Ambulatory Specialty Center - Northwest Valley
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX CHILDREN'S HOSPITAL, INC.
Authorized official
RAHEEL FAROUGH (SVP, MANAGED CARE & PAYOR STRATEGY)
(602) 933-3548
Entity
Organization
Contact information
Practice address
20325 N 51ST AVE, STE 116, GLENDALE, AZ 85308-5674
(602) 933-0003
(602) 933-6152
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
07/15/2009
Last updated
05/22/2023
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