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General NPI Number Information
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NPI Number | 1326080425
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Entity Type | Organization
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Legal Business Name | TON SANTA ROSA HEALTH CENTER
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | FEDERAL ROUTE 15, MILEPOST 12
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City | SELLS
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State | AZ
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Zip | 85634
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Country | US
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Telephone | 520-361-2403
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31001-0663
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City | PASADENA
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State | CA
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Zip | 91110-0663
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. VERONICA GERONIMO
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Credential |
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Telephone | 520-383-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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