Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm.

Organization Active NPI Public Health or Welfare Agency · Scottsdale, AZ

NPI 1093739740 · NPPES record last updated May 26, 2021

Key facts

NPI
1093739740
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM.
Practice address
10005 E Osborn Rd
Scottsdale, AZ 85256-4019
Phone
(602) 263-1200
Fax
(602) 263-1618
NPI assigned
Jul 26, 2006
Organization subpart
No

Authorized official

Name
Miss Laura A Tillman, MD
Title
Cmo
Phone
(602) 263-1674

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031105000797 TX Part B Supplier - Clinic/Group Practice 1759290901 Receives reassigned benefits from 636 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camp Verde, AZ; Gila Bend, AZ; Maricopa, AZ; Phoenix, AZ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Yes

Addresses

Primary practice location

10005 E Osborn Rd
Scottsdale, AZ 85256-4019

Mailing address

PO Box 95460
Cleveland, OH 44101-0033
Phone (602) 581-6088

Other identifiers

IdentifierTypeStateIssuer
092453MedicaidAZ
P0109880OtherAZBCBS

Other names

  • Salt River Facility Doing business as

Other providers in Scottsdale, AZ

All providers in Scottsdale, AZ · Public Health or Welfare Agency in Arizona

Sources for this page

Verify at the official NPI Registry.