Healthcare Provider Details

I. General information

NPI: 1811165319
Provider Name (Legal Business Name): TON SAN SIMON HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 11/18/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 86, MILEPOST 84
SELLS AZ
85634
US

IV. Provider business mailing address

DHHS PHS IHS TUCSON AREA PO BOX 31001-1021
PASADENA CA
91110-1021
US

V. Phone/Fax

Practice location:
  • Phone: 520-362-7007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. LYNNITA M HOFFMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 520-383-7200