Organization
CITY OF SIERRA VISTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LOUCKS (JR. ACCOUNTANT)
(520) 439-2162
Entity
Organization
Contact information
Practice address
1011 N CORONADO DR, SIERRA VISTA, AZ 85635-6334
(520) 439-2162
(520) 417-6932
Mailing address
1011 N CORONADO DR, SIERRA VISTA, AZ 85635-6334
(520) 439-2162
(520) 417-6932
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
25
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000810
HEALTH PLUS
MI
05
—
070350
—
AZ
01
—
189983600
US DEPT OF LABOR
KY
01
—
AZ0150630
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
07/06/2006
Last updated
01/07/2025
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