Organization
SUNSITES PEARCE FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MICHELE ALLEN (ADMINISTRATIVE SECRETARY)
(520) 826-3645
Entity
Organization
Contact information
Practice address
105 N TRACY ROAD, PEARCE, AZ 85625-0412
(520) 826-3645
(520) 826-3586
Mailing address
PO BOX 507, PEARCE, AZ 85625-0507
(520) 826-3645
(520) 826-3586
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
33
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071316
—
AZ
01
—
071316001
AZ PHY IPA
AZ
01
—
8100606
PACIFICARE SECURE HORIZON
AZ
Enumeration date
09/09/2005
Last updated
01/23/2025
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