Basic Information
| Provider Information | |||||||||
| NPI: | 1114533205 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VHS OUTPATIENT CLINICS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3811 E BELL RD STE 309 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804200749 | ||||||||
| FaxNumber: | 4804200732 | ||||||||
| Practice Location | |||||||||
| Address1: | 3811 E BELL RD STE 309 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804200749 | ||||||||
| FaxNumber: | 4804200732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2020 | ||||||||
| LastUpdateDate: | 09/23/2020 | ||||||||
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| AuthorizedOfficialLastName: | RASMUS | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP, CFO TPR | ||||||||
| AuthorizedOfficialTelephone: | 4698932532 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.