Healthcare Provider Details

I. General information

NPI: 1770661977
Provider Name (Legal Business Name): CARONDELET HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N ALVERNON WAY SUITE 181
TUCSON AZ
85711-1843
US

IV. Provider business mailing address

2202 N FORBES BLVD
TUCSON AZ
85745-1412
US

V. Phone/Fax

Practice location:
  • Phone: 520-873-3000
  • Fax:
Mailing address:
  • Phone: 520-872-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberH0099
License Number StateAZ

VIII. Authorized Official

Name: MR. TOM R PEPPING
Title or Position: CFO
Credential:
Phone: 520-872-7790