Organization
MARANA HEALTH CENTER, INC
Active
Parent organization
MARANA HEALTH CENTER, INC
Other names
West Side Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARANA HEALTH CENTER, INC
Authorized official
MR. CLINTON KUNTZ CEO (CEO)
(520) 682-4111
Entity
Organization
Contact information
Practice address
2202 W ANKLAM RD, TUCSON, AZ 85709-0001
(520) 616-6790
(520) 622-0849
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OCT4381
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
329592
AHCCCS GROUP NUMBER
AZ
05
—
928895
—
AZ
Enumeration date
05/16/2008
Last updated
02/27/2018
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