Healthcare Provider Details

I. General information

NPI: 1255384558
Provider Name (Legal Business Name): ORO VALLEY HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E TANGERINE RD
ORO VALLEY AZ
85755-6213
US

IV. Provider business mailing address

PO BOX 849870
DALLAS TX
75284-9870
US

V. Phone/Fax

Practice location:
  • Phone: 520-901-3500
  • Fax: 520-901-3525
Mailing address:
  • Phone: 520-901-3500
  • Fax: 520-901-3525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberH-3683
License Number StateAZ

VIII. Authorized Official

Name: LAURIE HOLTSFORD
Title or Position: DIRECTOR
Credential:
Phone: 615-465-7466