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General NPI Number Information
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NPI Number | 1770581639
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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 | 07/13/2005
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Last Update Date | 11/15/2024
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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 | 7900 S J STOCK RD
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City | TUCSON
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State | AZ
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Zip | 85746-7012
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Country | US
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Telephone | 520-547-8140
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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 | 520-547-8140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number |
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License Number State |
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