Organization
MARANA HEALTH CENTER, INC
Active
Organization
MARANA HEALTH CENTER, INC
Active
Other names
Dove Mountain Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA B CARZOLI PHARMD (CEO)
(520) 682-4111
Entity
Organization
Contact information
Practice address
5224 W DOVE CENTRE RD, MARANA, AZ 85658-5063
(520) 616-1445
(520) 616-1446
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 616-1445
(520) 616-1446
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC7878
AZ
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
OTC7878
AZ
261QU0200X
Urgent Care Clinic/Center
OTC7878
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210156
—
AZ
01
—
329592
GROUP MEDICAID
AZ
Enumeration date
09/01/2016
Last updated
05/06/2024
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