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Contact Information

MAYO CLINIC ARIZONA
5777 E MAYO BLVD
PHOENIX, AZ85054-4502
 Phone: 480-301-0881
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MAYO CLINIC ARIZONA

NPI # 1902877855
LBN Legal business name MAYO CLINIC ARIZONA
Authorized official JEFFREY JACKSON - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/30/2006
Last updated 04/16/2026 - About 2 months ago
Identifiers
AZ License # 4044
AZ Medicaid 912867
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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