Organization
PASCUA YAQUI TRIBE
Active
Parent organization
PASCUA YAQUI TRIBE
Other names
Pascua Yaqui Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
PASCUA YAQUI TRIBE
Authorized official
LINDA GUERRERO (DELEGATED OFFICIAL)
(520) 879-6039
Entity
Organization
Contact information
Practice address
4567 W TETAKUSIM RD, TUCSON, AZ 85746-9713
(520) 879-6373
Mailing address
7490 S CAMINO DE OESTE, TUCSON, AZ 85746-9308
(512) 879-6000
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
570192
—
AZ
Enumeration date
05/16/2022
Last updated
06/27/2023
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