MEDICARE: UNIVERSITY MEDICAL CENTER CORP

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	282NC0060X	Critical Access Hospital	RN134291	AZ

General Provider Information

NPI Number	:	1962669929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	3015 N MOUNTAIN AVE
Second Line	:	# 1
City	:	TUCSON
State	:	AZ
Zip	:	85719-2637
Country	:	US
Telephone Number	:	520-780-7632
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 N MOUNTAIN AVE
Second Line	:	# 1
City	:	TUCSON
State	:	AZ
Zip	:	85719-2637
Country	:	US
Telephone Number	:	520-780-7632
Fax Number	:

Authorized Official
Title or Position	:	INTERN MANAGER OF 4NW CV ICU
Name	:	MRS. KATHY JOY
Credential	:
Telephone Number	:	520-694-5046

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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