MEDICARE: EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1932777489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC

Provider Business Mailing Address
First Line	:	PO BOX 1231
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85702-1231
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:

Provider Business Practice Location Address
First Line	:	4550 S PALO VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714-1943
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CLINTON KUNTZ
Credential	:
Telephone Number	:	520-309-2012

Provider Enumeration Date	:	06/11/2021
Last Update Date	:	05/28/2025

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