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General NPI Number Information
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NPI Number | 1114013232
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Entity Type | Organization
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Legal Business Name | TRANSMED OF SOUTHERN ARIZONA
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 JOSHUA TREE DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-1256
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Country | US
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Telephone | 520-439-4340
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Fax | 520-458-0798
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Provider Business Mailing Address
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Address Line | 1100 JOSHUA TREE DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-1256
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Country | US
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Telephone | 520-439-4340
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Fax | 520-458-0798
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Authorized Official
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Title or Position | CEO
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Name | MR. HECTOR JESSE FIGUEROA
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Credential |
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Telephone | 520-439-4340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 549694
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License Number State | AZ
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