Organization
MARANA HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON G KUNTZ (CEO)
(520) 682-4111
Entity
Organization
Contact information
Practice address
13395 N MARANA MAIN ST, MARANA, AZ 85653-7008
(520) 682-1095
(520) 682-2196
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4560
(520) 682-3299
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
4075
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
329592
AHCCCS GROUP NUMBER
AZ
05
—
510768
—
AZ
Enumeration date
01/17/2007
Last updated
10/04/2017
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