Provider Demographics
NPI:1538315288
Name:NORTH PHOENIX HEALTH INSTITUTE
Entity type:Organization
Organization Name:NORTH PHOENIX HEALTH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-879-7580
Mailing Address - Street 1:711 E CAREFREE HWY STE 208
Mailing Address - Street 2:NORTH PHOENIX HEALTH INSTITUTE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-0109
Mailing Address - Country:US
Mailing Address - Phone:623-879-7580
Mailing Address - Fax:623-879-7510
Practice Address - Street 1:711 E CAREFREE HWY STE 208
Practice Address - Street 2:NORTH PHOENIX HEALTH INSTITUTE
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-0109
Practice Address - Country:US
Practice Address - Phone:623-879-7580
Practice Address - Fax:623-879-7510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1878261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ253899Medicaid
AZ253899Medicaid
AZZ0000BGMJPMedicare PIN