Healthcare Provider Details

I. General information

NPI: 1770581639
Provider Name (Legal Business Name): TON SANTA ROSA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FEDERAL ROUTE 15, MILEPOST 12
SELLS AZ
85634
US

IV. Provider business mailing address

7900 S J STOCK RD
TUCSON AZ
85746-7012
US

V. Phone/Fax

Practice location:
  • Phone: 520-361-2403
  • Fax:
Mailing address:
  • Phone: 520-547-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. VERONICA GERONIMO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 520-547-8140