Organization
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Active
Other names
Maricopa Integrated Health, Valleywise Comprehensive Health Center - Peoria
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA S FOWLER (SYSTEM DIRECTOR OF REIMBURSEMENT)
(602) 344-2830
Entity
Organization
Contact information
Practice address
8088 W WHITNEY DR, PEORIA, AZ 85345-6564
(833) 855-9973
Mailing address
PO BOX 29670, PHOENIX, AZ 85038-9670
(602) 344-8178
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
H3673
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189350800
UD DEPT OF LABOR
AZ
01
—
29517
PHOENIX INDIAN MEDICAL CENTER
AZ
01
—
500005
EVERCARE CHOICE
AZ
01
—
631935
AETNA
AZ
05
—
987495
—
AZ
01
—
AZ0205850
BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0947
HEALTHNET OF AZ
AZ
Enumeration date
03/26/2014
Last updated
06/21/2023
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