Healthcare Provider Details

I. General information

NPI: 1881683126
Provider Name (Legal Business Name): TUCSON MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

PO BOX 31267
TUCSON AZ
85751-1267
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-4952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberH-0012
License Number StateAZ

VIII. Authorized Official

Name: NATE TANPIENGCO
Title or Position: CORPORATE SR VP - CFO
Credential:
Phone: 520-324-1160