Organization
TON SANTA ROSA HEALTH CENTER
Active
Other names
SANTA ROSA HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VERONICA GERONIMO (CHIEF EXECUTIVE OFFICER)
(520) 547-8140
Entity
Organization
Contact information
Practice address
FEDERAL ROUTE 15, MILEPOST 12, SELLS, AZ 85634
(520) 361-2403
Mailing address
7900 S J STOCK RD, TUCSON, AZ 85746-7012
(520) 547-8140
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327177
NACADP#
AZ
01
—
03D0864300
CLIA #
AZ
05
—
147141-03
—
AZ
01
—
1770581639
FACILITY PROVIDER #
AZ
01
—
AZ0109850
BC/BS AZ DENTAL PROV NO
AZ
01
—
AZ0490080
BC/BS AZ PROV NO
AZ
Enumeration date
07/13/2005
Last updated
11/15/2024
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