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13395 N Marana Main St Marana AZ 85653-7008 | |
(520) 682-4111 | |
(520) 682-3817 |
Full Name | |
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Speciality | Clinic/Center |
Location | 13395 N Marana Main St, Marana, 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 | 13395 N Marana Main St Marana AZ 85653-7008 Ph: (520) 682-4111 |
NPI Number | 1164526471 |
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Provider Enumeration Date | 09/08/2006 |
Last Update Date | 05/06/2024 |
Medicare PECOS PAC ID | 2365348091 |
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Medicare Enrollment ID | O20100720000610 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164526471 | NPI | - | NPPES |
329592 | Other | AZ | AHCCCS GROUP NUMBER |
929343 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | OTC-0032 (Arizona) | Primary |
Marana Teen Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13644 N Sandario Rd, Marana, AZ 85653 Phone: 520-682-4730 Fax: 520-682-4790 | |
Gladden Farms Chiropractic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11719 W Boll Bloom Dr, Marana, AZ 85653 Phone: 602-405-2553 |