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General NPI Number Information
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NPI Number | 1487537445
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Entity Type | Organization
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Legal Business Name | MARIPOSA COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 507 N WESTERN AVE
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City | NOGALES
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State | AZ
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Zip | 85621-2060
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Country | US
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Telephone | 520-287-4747
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Fax | 520-281-4487
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Provider Business Mailing Address
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Address Line | 825 N GRAND AVE STE 100
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City | NOGALES
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State | AZ
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Zip | 85621-1061
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Country | US
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Telephone | 520-761-2128
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Fax | 520-281-1112
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Authorized Official
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Title or Position | CHIEF OF ADMINISTRATION
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Name | TIA DUNCAN
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Credential |
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Telephone | 520-761-2128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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