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General NPI Number Information
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NPI Number | 1467439091
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Entity Type | Organization
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Legal Business Name | EL RIO HEALTH CENTER PHARMACY
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 839 W CONGRESS ST
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City | TUCSON
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State | AZ
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Zip | 85745-2819
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Country | US
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Telephone | 520-670-3724
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Fax | 520-670-3842
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Provider Business Mailing Address
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Address Line | 839 W CONGRESS ST
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City | TUCSON
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State | AZ
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Zip | 85745-2819
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Country | US
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Telephone | 520-670-3724
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Fax | 520-670-3842
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Authorized Official
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Title or Position | CEO
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Name | CLINTON G KUNTZ
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Credential |
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Telephone | 520-601-0607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | Y00805
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License Number State | AZ
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