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General NPI Number Information
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NPI Number | 1063274868
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Entity Type | Organization
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Legal Business Name | SAN LUIS WALK-IN CLINIC, INC.
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 950 E MAIN ST BLDG C
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City | SOMERTON
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State | AZ
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Zip | 85350-7409
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Country | US
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Telephone | 928-324-1040
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Fax | 928-324-1044
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | SOMERTON
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State | AZ
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Zip | 85350-0617
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Country | US
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Telephone | 928-662-0406
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Fax | 928-662-0407
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | AMANDA AGUIRRE
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Credential |
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Telephone | 928-315-7910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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