Arizona Grand Medical Center PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ARIZONA GRAND MEDICAL CENTER PLLC

Doing business as

Arizona Grand Medical Center- Crossings 2

Practice address

3773 Crossings Dr
Suite B
Prescott, AZ 86305-7140

Phone

(602) 550-4065

Fax

(623) 934-5603

NPI assigned

Aug 8, 2014

Last updated

Aug 8, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

ARIZONA GRAND MEDICAL CENTER, PLLCAs reported in NPPES

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

Authorized official

Name

Satwant Bhowra

Title

Cfo

Phone

(602) 550-4065

Specialties & licenses 1

Addresses

Other names 1

• Arizona Grand Medical Center- Crossings 2 Doing business as

Part of

Arizona Grand Medical C

Locations

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1720497258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47729",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850687729",
            "telephone_number": "602-550-4065",
            "fax_number": "623-934-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3773 CROSSINGS DR",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057140",
            "telephone_number": "602-550-4065",
            "fax_number": "623-934-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA GRAND MEDICAL CENTER PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA GRAND MEDICAL CENTER, PLLC",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "BHOWRA",
        "authorized_official_first_name": "SATWANT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-550-4065"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Grand Medical Center- Crossings 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.