Provider Demographics
NPI:1699909630
Name:ARIZONA FOUNDATION FOR THE CHANGING EYE
Entity type:Organization
Organization Name:ARIZONA FOUNDATION FOR THE CHANGING EYE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:B
Authorized Official - Last Name:GUIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-251-3400
Mailing Address - Street 1:4602 N 16TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5189
Mailing Address - Country:US
Mailing Address - Phone:602-251-3400
Mailing Address - Fax:602-251-3415
Practice Address - Street 1:4602 N 16TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5189
Practice Address - Country:US
Practice Address - Phone:602-251-3400
Practice Address - Fax:602-251-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory