Healthcare Provider Details

I. General information

NPI: 1063597169
Provider Name (Legal Business Name): CARONDELET HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 W ST MARY'S ROAD
TUCSON AZ
85745-2623
US

IV. Provider business mailing address

2202 NORTH FORBES BLVD
TUCSON AZ
85745-1412
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberHSPC0002
License Number StateAZ

VIII. Authorized Official

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