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Contact Information

MARYVALE PEDIATRIC CLINIC
4700 N. 51ST AVENUE
SUITE #4
PHOENIX, AZ85031
 Phone: 623-846-7575
 Fax: 623-846-3778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MARYVALE PEDIATRIC CLINIC

NPI Number 1366605529
LBN Legal business name MARYVALE PEDIATRIC CLINIC
Authorized official HARRY BROOME - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/08/2008
Last updated 01/22/2015 - About 11 years 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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