MOUNTAIN PARK HEALTH CENTER (NPI# 1578741120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578741120 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
6601 W Thomas Rd Phoenix AZ 85033-5700 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6023238181 |
| Practice Fax Number | 6022471238 |
| Mailing Telephone | 6023233242 |
| Mailing Fax Number | 6023233496 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | MARY SOTO (ASSOCIATE PHARMACY DIRECTOR) |
| Authorized Official Telephone | 6025863026 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
4078 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BOARD OF PHARMACY | 4078 | 01 |
| AZ | 914912 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4616 N 51st Ave Suite 101, Phoenix, AZ 85031 | 6023238170 | 6232431236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1922105204 | Mountain Park Health Center | Clinic/Center | 140 N Litchfield Rd Ste 200&106, Goodyear, AZ 85338-1277 | 2006-09-20 |
| 1811490881 | Mountain Park Health Center | Clinic/Center | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-03-15 |
| 1487037958 | Mountain Park Health Center | Clinic/Center | 5517 N 17th Ave, Phoenix, AZ 85015-2516 | 2015-07-02 |
| 1386027852 | Mountain Park Health Center | Clinic/Center | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2015-07-02 |
| 1740663210 | Mountain Park Health Center | Clinic/Center | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2015-07-02 |
| 1669878567 | Mountain Park Health Center | Clinic/Center | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2014-11-05 |
| 1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
| 1740387018 | Mountain Park Health Center | Clinic/Center | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2006-09-20 |
| 1376640656 | Mountain Park Health Center | Clinic/Center | 1840 E Broadway Rd, Tempe, AZ 85282-1614 | 2006-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNTAIN PARK HEALTH CENTER | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 |
| Street Address |
6601 W THOMAS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85033-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588665061 | Joyce Morgan | Nurse Practitioner | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2005-08-09 |
| 1982216156 | Kara Larter | Nurse Practitioner | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2020-08-19 |
| 1093330532 | Jose Leon Godinez | Nurse Practitioner | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2020-06-10 |
| 1366066755 | Stacy Lee | Pharmacist | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2020-06-02 |
| 1538792205 | Maria Anzures | Nurse Practitioner | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2020-02-20 |
| 1538706478 | Anthony Joseph Carano | Registered Nurse | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2019-12-10 |
| 1558906040 | Makenzie Michelle Brown | Dietitian, Registered | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2019-11-08 |
| 1952951683 | Abigail Grace-lynn Noblett | Dietitian, Registered | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2019-09-14 |
| 1134774185 | Destinee Amie Campbell | Dietitian, Registered | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2019-08-06 |
| 1932752870 | Maria Talpos | Dental Hygienist | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2019-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376162073 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4136 North 75th Ave, Suite 116, Room P, Phoenix, AZ 85033 | 2020-04-13 |
| 1942849146 | Risas O.s. Dental Partners Az LLC | Dentist | 7442 W. Thomas Rd., Phoenix, AZ 85033 | 2020-01-06 |
| 1326458555 | Norman Loya | Private Vehicle | 7620 W Wolf St, Phoenix, AZ 85033 | 2014-04-28 |
| 1598188641 | Arlena Lawrence | Health Educator | 6602 W. Osborn Rd., Phoenix, AZ 85033 | 2014-01-27 |
| 1083921076 | Beth Marie Elia | Psychologist | 6601 W. Thomas Rd., Phoenix, AZ 85033 | 2010-09-12 |
| 1720317647 | Nguyen Quoc Tang | Pharmacist | 8325 W Indian Schood Rd, Phoenix, AZ 85033 | 2009-12-24 |
| 1760635775 | Sarah Bess Stauffer | Occupational Therapist | 3401 N. 67th Ave, Phoenix, AZ 85033 | 2008-11-04 |
| 1578748968 | Pain and Rehab Consultants LLC | Pain Medicine | 7400 W Indian School Rd, 114, Phoenix, AZ 85033 | 2008-01-03 |
| 1902023930 | Smile Dental Group | Dentist | 6524 W Indian School Road, Suite A, Phoenix, AZ 85033 | 2007-04-19 |
| 1801955067 | Reva Mae Mckenzie | Technician | 4615 No 82nd Lane, Phoenix, AZ 85033 | 2006-12-06 |
| Find all providers in zip 85033 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215567011 | Kleins of Jacksonville Inc | Pharmacy | 14330 Jarrettsville Pike, Phoenix, MD 21131-1743 | 2020-01-21 |
| 1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
| 1497848824 | Banner Health | Pharmacy | 925 E Mcdowell Rd, Phoenix, AZ 85006-2502 | 2006-09-30 |
| 1598867996 | Banner Health | Pharmacy | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154989168 | Community Hospital Association, Inc. | Pharmacy | 26750b S. Santa Fe Rd., Congress, AZ 85332 | 2019-06-04 |
| 1154688927 | Marana Health Center Inc | Pharmacy | 899 N Wilmot Rd Ste B, Tucson, AZ 85711-1712 | 2012-04-18 |
| 1245357706 | West Kingman Pharmacy, LLC | Pharmacy | 3135 N Stockton Hill Rd, Kingman, AZ 86401 | 2007-03-22 |
| 1649334442 | North Country Healthcare, Inc. | Pharmacy | 2920 North 4th Street, Flagstaff, AZ 86004 | 2006-12-19 |
| 1730295684 | State of Arizona | Pharmacy | 1295 N Martin, Tucson, AZ 85721-0001 | 2006-08-22 |
| 1023122843 | Cardiojost, Inc | Pharmacy | 140 S Power Rd Ste 102, Mesa, AZ 85206-5297 | 2006-08-18 |
| 1376502054 | Sunset Community Health Center Inc | Pharmacy | 815 E Cesar Chavez Blvd, San Luis, AZ 85349 | 2006-03-21 |
| 1275519241 | El Rio Health Center (southwest) | Pharmacy | 1510 W Commerce Court, Tucson, AZ 85746-6015 | 2005-12-21 |
| 1447242417 | Cigna Health Care of Arizona Inc | Pharmacy | 1920 E Baseline Rd, Tempe, AZ 85283-1511 | 2005-08-16 |
| 1992797930 | Cigna Health Care of Arizona Inc | Pharmacy | 9069 W Thunderbird, Peoria, AZ 85381 | 2005-08-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.