Healthcare Provider Details
I. General information
NPI: 1457439150
Provider Name (Legal Business Name): CARONDELET HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 N WILMOT RD
TUCSON AZ
85711-2602
US
IV. Provider business mailing address
2202 N FORBES BLVD
TUCSON AZ
85745-1412
US
V. Phone/Fax
- Phone: 520-873-3000
- Fax:
- Phone: 520-872-7700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | H0099 |
| License Number State | AZ |
VIII. Authorized Official
Name: MR.
ALAN
STRAUSS
Title or Position: CFO
Credential:
Phone: 520-872-7790