Healthcare Provider Details

I. General information

NPI: 1396068615
Provider Name (Legal Business Name): PINAL COUNTY PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S. CENTRAL
FLORENCE AZ
85132
US

IV. Provider business mailing address

PO BOX 2945
FLORENCE AZ
85132-3055
US

V. Phone/Fax

Practice location:
  • Phone: 520-866-7320
  • Fax: 520-866-7358
Mailing address:
  • Phone: 520-866-7320
  • Fax: 520-866-7358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: GWENA VINCENT
Title or Position: ACCOUNTING/BILLING
Credential:
Phone: 520-866-7320