Provider Demographics
NPI:1669870937
Name:VHS OF PHOENIX INC
Entity type:Organization
Organization Name:VHS OF PHOENIX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KELSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-246-5922
Mailing Address - Street 1:1445 ROSS AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-2711
Mailing Address - Country:US
Mailing Address - Phone:469-893-2200
Mailing Address - Fax:469-893-7272
Practice Address - Street 1:2000 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2443
Practice Address - Country:US
Practice Address - Phone:602-249-0212
Practice Address - Fax:602-246-5849
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VHS OF PHOENIX INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
03T030Medicare Oscar/Certification