Provider Demographics
NPI:1295968261
Name:DONOR NETWORK OF ARIZONA
Entity type:Organization
Organization Name:DONOR NETWORK OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINACE
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-222-2275
Mailing Address - Street 1:2010 W RIO SALADO PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3819
Mailing Address - Country:US
Mailing Address - Phone:602-222-2200
Mailing Address - Fax:602-222-2202
Practice Address - Street 1:2010 W RIO SALADO PKWY
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-3819
Practice Address - Country:US
Practice Address - Phone:602-222-2200
Practice Address - Fax:602-222-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335U00000XSuppliersOrgan Procurement Organization
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
03-HL03Medicare PIN
03-PO01Medicare PIN