Provider Demographics
NPI:1417790965
Name:WOMEN'S HEALTH INNOVATIONS OF ARIZONA
Entity type:Organization
Organization Name:WOMEN'S HEALTH INNOVATIONS OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-612-1320
Mailing Address - Street 1:9280 S KYRENE RD STE 119
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2954
Mailing Address - Country:US
Mailing Address - Phone:480-339-7119
Mailing Address - Fax:
Practice Address - Street 1:9280 S KYRENE RD STE 119
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2954
Practice Address - Country:US
Practice Address - Phone:480-339-7119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S HEALTH INNOVATIONS OF ARIZONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health