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General NPI Number Information
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NPI Number | 1568658870
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Entity Type | Organization
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Legal Business Name | HIGH DESERT CLINIC URGENT AND OCCUPATIONAL CARE LLC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 77 E FRY BLVD
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City | SIERRA VISTA
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State | AZ
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Zip | 85635
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Country | US
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Telephone | 520-459-8915
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Fax | 520-458-9424
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Provider Business Mailing Address
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Address Line | PO BOX 17689
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City | TUCSON
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State | AZ
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Zip | 85731-7689
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Country | US
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Telephone | 520-885-2231
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Fax | 520-885-2471
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN GLUCK
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Credential | MD
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Telephone | 520-885-2231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | AZ
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