Organization
DHHS-PHS, IHS TUCSON AREA
Active
Other names
IHS TUCSON SANTA ROSA CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT PRIESSMAN B.A., M.B.A., C.P.M. (ACCOUNTING AND BUGET OFFICER)
(520) 295-2427
Entity
Organization
Contact information
Practice address
FEDERAL ROUTE 15, SANTA ROSA VILLAGE, AZ 85634
(520) 361-2261
(520) 383-5572
Mailing address
7900 S J STOCK RD, TUCSON, AZ 85746-7012
(520) 295-2427
(520) 295-2611
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0327177
NACADP #
AZ
05
—
147141-03
—
AZ
01
—
1770581639
FACILITY NPI #
AZ
05
—
706921-01
—
AZ
05
—
907008-01
—
AZ
01
—
AZ0490080
BC/BS AZ PROVIDER #
AZ
Enumeration date
05/03/2006
Last updated
10/17/2007
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