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General NPI Number Information
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NPI Number | 1093270035
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Entity Type | Organization
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Legal Business Name | EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER INC
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 101 W IRVINGTON RD BLDG # 10
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City | TUCSON
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State | AZ
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Zip | 85714
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Country | US
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Telephone | 520-309-4585
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Fax | 520-309-4589
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Provider Business Mailing Address
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Address Line | 839 W CONGRESS
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City | TUCSON
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State | AZ
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Zip | 85745
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Country | US
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Telephone | 520-670-3813
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Fax | 520-670-7560
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Authorized Official
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Title or Position | PHARMACY COORDINATOR
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Name | MRS. ELVA AMELIA GONZALEZ
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Credential | D.O.
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Telephone | 520-670-3813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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