Freedom Park | |
5000 E 29th St Tucson AZ 85711-6401 | |
(520) 790-8500 | |
(520) 790-8505 |
Full Name | Freedom Park |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 5000 E 29th St, Tucson, Arizona |
Authorized Official Name and Position | Clinton Kuntz (CEO) |
Authorized Official Contact | 5206824111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Freedom Park Po Box 188 Marana AZ 85653-0188 Ph: (520) 682-4111 | Freedom Park 5000 E 29th St Tucson AZ 85711-6401 Ph: (520) 790-8500 |
NPI Number | 1023177250 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 02/20/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023177250 | NPI | - | NPPES |
417356 | Medicaid | AZ | |
329592 | Other | AZ | AHCCCS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Arizona) | Primary |
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