P.E.T. SCAN ARIZONA LLC NPI 1083616569

NPI Information

  • NPI: 1083616569
  • Provider Name: P.E.T. SCAN ARIZONA LLC
  • Classification: Clinic/Center - 261QR0200X
  • Specialization: Radiology
  • Entity Type: Organization
  • Address: 6036 N 19TH AVE
    SUITE 305
    PHOENIX, AZ
    ZIP 85015
  • Phone: (602) 589-7226

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NPI Details

P.E.T. SCAN ARIZONA LLC is a radiology clinic center in Phoenix, AZ. P.E.T. SCAN ARIZONA LLC NPI is 1083616569. The provider is registered as an organization entity type.

The provider's business location address is:

6036 N 19TH AVE
SUITE 305
PHOENIX, AZ
ZIP 85015-106
Phone: (602) 589-7226
Fax: (602) 589-0816

The provider's authorized official is Terry A. Brown .
The authorized official title is Executive Director and has the following contact phone number (602) 589-7226.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 7/21/2022.

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
1261QR0200XClinic/CenterRadiologyARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11Z7140OTHERARIZONAHEALTH NET
2555386MEDICAIDARIZONA
3AZ0891570OTHERARIZONABCBS AZ
41083616569OTHERNPI

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: 11/21/2025

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