OrganizationActive
Revolution Medical Center, Inc
NPI 1376727610 · Non-Pharmacy Dispensing Site · Phoenix, AZ
Provider details
- NPI number
- 1376727610
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Revolution Medical Center, Inc
- Organization subpart
- Yes
- Authorized official
- Jesse Haggard, Clinic Director(602) 463-7177
- License
- 04836D (AZ)
Specialties & taxonomies
Suppliers
Practice location
2015 E Camelback Rd
Phoenix, AZ 85016-4710
Phone: (602) 840-4400
Fax: (602) 840-0490
Approximate (ZIP-level) locationGet directions
Mailing address
2015 E Camelback Rd
Phoenix, AZ 85016-4710
Registry dates
- Enumerated
- 2007-12-21
- Last updated
- 2007-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.