Organization
SOUTHWEST NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY B. HENNING (CEO)
(602) 285-4340
Entity
Organization
Contact information
Practice address
1840 N 95TH AVE STE 132, PHOENIX, AZ 85037-4445
(623) 932-6950
(623) 932-7995
Mailing address
2700 N CENTRAL AVE, SUITE 1050, PHOENIX, AZ 85004-1133
(602) 266-8402
(602) 264-0887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
OTC6612
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC6612
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361554
—
AZ
01
—
Z127516
MEDICARE PTAN
AZ
Enumeration date
05/16/2008
Last updated
02/18/2025
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