Azore II, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI2661 Issued in AZ

Legal business name

AZORE II, LLC

Practice address

6246 N 19TH Ave
Phoenix, AZ 85015-1511

Phone

(602) 433-6300

Fax

(602) 433-6458

NPI assigned

Jun 21, 2006

Organization subpart

Yes

Parent organization

PINNACLE HEALTHCARE, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Garber

Title

Chief Financial Officer

Phone

(541) 746-1020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Chris Ridge Premier Care & Rehabilitation Center Doing business as

Part of

Pinnacle Healthcare Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1124064605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GATEWAY LOOP",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771114",
            "telephone_number": "541-746-1020",
            "fax_number": "541-284-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6246 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151511",
            "telephone_number": "602-433-6300",
            "fax_number": "602-433-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZORE II, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE HEALTHCARE, INC.",
        "enumeration_date": "2006-06-21",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "541-746-1020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI2661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137010",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chris Ridge Premier Care & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.