MEDICARE: SOUTHERN ARIZONA URGENT CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center	OTC7790	AZ

General Provider Information

NPI Number	:	1386003788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN ARIZONA URGENT CARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 689022
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-9022
Country	:	US
Telephone Number	:	615-465-7396
Fax Number	:	615-628-6877

Provider Business Practice Location Address
First Line	:	90 W RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5130
Country	:	US
Telephone Number	:	520-544-2273
Fax Number	:	520-544-4227

Authorized Official
Title or Position	:	DIRECTOR PROVIDER ENROLLMENT
Name	:	KRISTY MUSIC
Credential	:
Telephone Number	:	877-892-9815

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/18/2025

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