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Contact Information

STATE OF ARIZONA
24601 N 29TH AVE
PHOENIX, AZ85083-1165
 Phone: 623-780-1303
 Fax: 623-879-7026
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STATE OF ARIZONA

NPI # 1578752762
LBN Legal business name STATE OF ARIZONA
Authorized official RONALD WILLIAMS - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/24/2007
Last updated 04/12/2016 - About 10 years ago
Identifiers
AZ License # Y01936
Other 1988966 PK
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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