Healthcare Provider Details

I. General information

NPI: 1710353339
Provider Name (Legal Business Name): SMSJ TUCSON HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 W SAINT MARYS RD
TUCSON AZ
85745-2623
US

IV. Provider business mailing address

PO BOX 204702
DALLAS TX
75320-4702
US

V. Phone/Fax

Practice location:
  • Phone: 520-872-3000
  • Fax: 520-872-6279
Mailing address:
  • Phone: 469-893-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: CRISTIAN CORMIER
Title or Position: CFO
Credential:
Phone: 915-747-2634