Provider Demographics
NPI:1154875375
Name:MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
Entity type:Organization
Organization Name:MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-874-7114
Mailing Address - Street 1:234 N CENTRAL AVE
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2208
Mailing Address - Country:US
Mailing Address - Phone:602-506-3177
Mailing Address - Fax:
Practice Address - Street 1:234 N CENTRAL AVE
Practice Address - Street 2:SUITE 5000
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2208
Practice Address - Country:US
Practice Address - Phone:602-506-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARICOPA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center