| Organization Name: | BRIDGEWAY HEALTH SOLUTIONS OF ARIZONA, LLC |
| NPI Number: | 1679872220 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICK FREDRICKSON (CEO) |
| Mailing Address: | 2250 N Craycroft Rd Tucson |
| State: | AZ US |
| Postal Code: | 857122802 |
| Phone Number: | 5205463400 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2011 |
| NPI Last Update Date: | 08/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | BH3835 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |