=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215820253
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARANA HEALTH CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2025
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5224 W DOVE CENTRE RD
-----------------------------------------------------
City | MARANA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85658-5063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-682-1095
-----------------------------------------------------
Fax | 520-682-2196
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 188
-----------------------------------------------------
City | MARANA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85653-0188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-682-1095
-----------------------------------------------------
Fax | 520-682-2196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. JOSHUA B CARZOLI
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 520-682-4111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0002X
-----------------------------------------------------
Taxonomy Name | Clinic Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------