Provider Demographics
NPI:1861571093
Name:CIGNA HEALTH CARE OF ARIZONA, INC.
Entity type:Organization
Organization Name:CIGNA HEALTH CARE OF ARIZONA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:602-271-5426
Mailing Address - Street 1:25500 N NORTERRA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8200
Mailing Address - Country:US
Mailing Address - Phone:602-942-4462
Mailing Address - Fax:623-277-2335
Practice Address - Street 1:1473 N DYSART RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1548
Practice Address - Country:US
Practice Address - Phone:623-925-4931
Practice Address - Fax:623-882-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC 4101261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center