Healthcare Provider Details

I. General information

NPI: 1851571749
Provider Name (Legal Business Name): SAN SIMON UNIFIED SCHOOL DISTRICT #18
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 WEST BUSINESS I 10
SAN SIMON AZ
85632
US

IV. Provider business mailing address

PO BOX 38
SAN SIMON AZ
85632-0038
US

V. Phone/Fax

Practice location:
  • Phone: 520-845-2275
  • Fax: 520-845-2480
Mailing address:
  • Phone: 520-845-2275
  • Fax: 520-845-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH GUTHRIE
Title or Position: SUPERINTENDENT
Credential:
Phone: 520-845-2275