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ARIZONA BLEEDING DISORDERS HEALTH AND WELLNESS CENTER NPI 1982090338


NPI Information

NPI: 1982090338
Provider Name: ARIZONA BLEEDING DISORDERS HEALTH AND WELLNESS CENTER
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 03D2103480

Address:
821 N 5TH AVE
PHOENIX, AZ
ZIP 85003
Phone: (602) 680-7722
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ARIZONA BLEEDING DISORDERS HEALTH AND WELLNESS CENTER is a general practice in Phoenix, AZ. ARIZONA BLEEDING DISORDERS HEALTH AND WELLNESS CENTER NPI is 1982090338. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

821 N 5TH AVE
PHOENIX, AZ
ZIP 85003-315
Phone: (602) 680-7722
Fax: (602) 682-5135

The provider's authorized official is Kirby Holliday .
The authorized official title is Credentialing Manager and has the following contact phone number (480) 857-3900.

The CLIA number assigned to this NPI record is 03D2103480 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/13/2015 and was last updated on 7/6/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeOTC6802ARIZONAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OTC6802OTHERARIZONAOUTPATIENT TREATMENT CENTER LICENCE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.