Provider Demographics
NPI:1104935865
Name:ARCADIA RADIOLOGY & BREAST CENTER
Entity type:Organization
Organization Name:ARCADIA RADIOLOGY & BREAST CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL ASSISTANT
Authorized Official - Phone:623-487-7000
Mailing Address - Street 1:7200 W BELL RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8529
Mailing Address - Country:US
Mailing Address - Phone:623-487-7000
Mailing Address - Fax:623-487-7777
Practice Address - Street 1:4440 N 36TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3589
Practice Address - Country:US
Practice Address - Phone:602-956-1994
Practice Address - Fax:602-957-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ115279OtherGROUP PTAN
AZ238429Medicaid
AZ300046239OtherRAILROAD MEDICARE
AZD37383Medicare UPIN
AZ238429Medicaid