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General NPI Number Information
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NPI Number | 1396205886
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Entity Type | Organization
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Legal Business Name | SCVRH LLC
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 4455 S I 19 FRONTAGE RD
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5884
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Country | US
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Telephone | 520-393-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 4455 S I 19 FRONTAGE RD
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-5884
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Country | US
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Telephone | 520-393-4710
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | PAUL KRISTOPHER ZIEGELE
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Credential |
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Telephone | 520-383-4710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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