Healthcare Provider Details

I. General information

NPI: 1447447891
Provider Name (Legal Business Name): ORO VALLEY HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 N ORACLE RD
TUCSON AZ
85739-9554
US

IV. Provider business mailing address

PO BOX 849870
DALLAS TX
75284-9870
US

V. Phone/Fax

Practice location:
  • Phone: 520-901-3923
  • Fax:
Mailing address:
  • Phone: 520-901-3923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

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