| Phoenix Children's Ambulatory Specialty Center - Northwest Valley | |
|
20325 N 51st Ave Ste 116 Glendale AZ 85308-5674 | |
| (602) 933-0003 | |
| (602) 933-6152 |
| Full Name | Phoenix Children's Ambulatory Specialty Center - Northwest Valley |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 20325 N 51st Ave, Glendale, Arizona |
| Authorized Official Name and Position | Raheel Farough (SVP, MANAGED CARE & PAYOR STRATEGY) |
| Authorized Official Contact | 6029333548 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Children's Ambulatory Specialty Center - Northwest Valley 2108 E Thomas Rd Ste 130 Phoenix AZ 85016-0008 Ph: () - | Phoenix Children's Ambulatory Specialty Center - Northwest Valley 20325 N 51st Ave Ste 116 Glendale AZ 85308-5674 Ph: (602) 933-0003 |
| NPI Number | 1679703441 |
|---|---|
| Provider Enumeration Date | 07/15/2009 |
| Last Update Date | 05/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679703441 | NPI | - | NPPES |
| 876253 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | SH3107 (Arizona) | Primary |
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