STATE OF ARIZONA DEPARTMENT OF CORRECTIONS; NPI #1255566477

Contact Information

STATE OF ARIZONA DEPARTMENT OF CORRECTIONS

1305 E BUTTE AVE
FLORENCE, AZ 85232

Phone: 520-868-4011
Fax: 602-258-7886
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prison Health	261QP2400X

Indicates primary specialty

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NPI Profile & details for STATE OF ARIZONA DEPARTMENT OF CORRECTIONS

NPI Number 1255566477

LBN Legal business name STATE OF ARIZONA DEPARTMENT OF CORRECTIONS

Authorized official LINDSEY CHITWOOD - (PHYSICIAN ASSISTANT)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/18/2009

Last updated 05/18/2009 - About 17 years ago

Identifiers

License #

3816

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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