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Contact Information

ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
4315 E MAIN ST
MESA, AZ85205-8605
 Phone: 480-870-7500
 Fax: 480-906-2173
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC

NPI Number 1558026880
LBN Legal business name ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC
Authorized official AMY MODDESETTE - (SR. DIRECTOR, MANAGED CARE OPS)
Entity Organization
Organization subpart 1 No
Enumeration date 11/02/2021
Last updated 03/11/2026 - About 3 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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