| |
8088 W Whitney Dr Peoria AZ 85345-6564 | |
(833) 855-9973 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 8088 W Whitney Dr, Peoria, Arizona |
Authorized Official Name and Position | Kathleen Kirkland (PFS DIRECTOR) |
Authorized Official Contact | 6023448178 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 29670 Phoenix AZ 85038-9670 Ph: (602) 344-8180 | 8088 W Whitney Dr Peoria AZ 85345-6564 Ph: (833) 855-9973 |
NPI Number | 1952720708 |
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Provider Enumeration Date | 04/09/2014 |
Last Update Date | 04/26/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952720708 | NPI | - | NPPES |
946347 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
282N00000X | General Acute Care Hospital | H3673 (Arizona) | Secondary |
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