Provider Demographics
NPI:1447393152
Name:DIGNITY HEALTH
Entity type:Organization
Organization Name:DIGNITY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-275-8112
Mailing Address - Street 1:3033 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4447
Mailing Address - Country:US
Mailing Address - Phone:858-275-8112
Mailing Address - Fax:779-803-8118
Practice Address - Street 1:102 E LAKE MEAD PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-5575
Practice Address - Country:US
Practice Address - Phone:858-275-8112
Practice Address - Fax:779-803-8118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-14
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA659HOS-12273Y00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV190750100OtherUS DEPT OF LABOR
NV880059427890150008OtherTRICARECHAMPUS
880059427OtherIRS
NV1002873Medicaid
880059427890150000OtherTRICARECHAMPUS
NVNV6055OtherBLUE CROSS BLUE SHIELD
NV68477OtherAETNA
NV1102873Medicaid
NV1202873Medicaid
880059427890150000OtherTRICARECHAMPUS
NV190750100OtherUS DEPT OF LABOR
NV29T012Medicare Oscar/Certification