| |
2945 W Ina Rd Ste 221&215 Tucson AZ 85741-2350 | |
(520) 616-1531 | |
(520) 616-1536 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2945 W Ina Rd Ste 221&215, Tucson, Arizona |
Authorized Official Name and Position | Joshua B Carzoli (CEO) |
Authorized Official Contact | 5206824111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 188 Marana AZ 85653-0188 Ph: (520) 682-4111 | 2945 W Ina Rd Ste 221&215 Tucson AZ 85741-2350 Ph: (520) 616-1531 |
NPI Number | 1669245007 |
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Provider Enumeration Date | 11/06/2023 |
Last Update Date | 03/04/2024 |
Medicare PECOS PAC ID | 2365348091 |
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Medicare Enrollment ID | O20240708001045 |
Identifier | Type | State | Issuer |
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1669245007 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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