Healthcare Provider Details

I. General information

NPI: 1386003788
Provider Name (Legal Business Name): SOUTHERN ARIZONA URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 W RIVER RD
TUCSON AZ
85704-5130
US

IV. Provider business mailing address

PO BOX 689022
FRANKLIN TN
37068-9022
US

V. Phone/Fax

Practice location:
  • Phone: 520-544-2273
  • Fax: 520-544-4227
Mailing address:
  • Phone: 615-465-7396
  • Fax: 615-628-6877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOTC7790
License Number StateAZ

VIII. Authorized Official

Name: KRISTY MUSIC
Title or Position: DIRECTOR PROVIDER ENROLLMENT
Credential:
Phone: 877-892-9815