MARYVALE FACILITY GROUP LLC NPI 1053974592

NPI Information

NPI: 1053974592
Provider Name: MARYVALE FACILITY GROUP LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
7141 W THOMAS RD STE 102
PHOENIX, AZ
ZIP 85033
Phone: (480) 634-6400
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MARYVALE FACILITY GROUP LLC is an ambulatory surgical clinic center in Phoenix, AZ. MARYVALE FACILITY GROUP LLC NPI is 1053974592. The provider is registered as an organization entity type.

The provider's business location address is:

7141 W THOMAS RD STE 102
PHOENIX, AZ
ZIP 85033-518
Phone: (480) 634-6400
Fax: (480) 404-9649

The provider's authorized official is Challen Waychoff .
The authorized official title is Coo/manager and has the following contact phone number (480) 634-6400.

The enumeration date for this NPI number is 4/19/2019 and was last updated on 5/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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