Healthcare Provider Details

I. General information

NPI: 1275519241
Provider Name (Legal Business Name): EL RIO HEALTH CENTER (SOUTHWEST)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W COMMERCE COURT
TUCSON AZ
85746-6015
US

IV. Provider business mailing address

1510 W COMMERCE COURT
TUCSON AZ
85746-6015
US

V. Phone/Fax

Practice location:
  • Phone: 520-434-0678
  • Fax: 520-806-2631
Mailing address:
  • Phone: 520-434-0678
  • Fax: 520-806-2631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CLINTON G KUNTZ
Title or Position: CEO
Credential:
Phone: 520-601-0607