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14574 S. Sunland Gin Rd Arizona City AZ 85123 | |
(520) 387-5651 | |
(520) 387-6036 |
Full Name | |
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Speciality | Clinic/Center |
Location | 14574 S. Sunland Gin Rd, Arizona City, Arizona |
Authorized Official Name and Position | Daniel Barbara (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5203875651 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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410 N Malacate St Ajo AZ 85321-2254 Ph: (520) 387-5651 | 14574 S. Sunland Gin Rd Arizona City AZ 85123 Ph: (520) 387-5651 |
NPI Number | 1548794142 |
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Provider Enumeration Date | 04/20/2017 |
Last Update Date | 01/08/2024 |
Medicare PECOS PAC ID | 3476441866 |
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Medicare Enrollment ID | O20220817003214 |
Identifier | Type | State | Issuer |
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1548794142 | NPI | - | NPPES |