MEDICARE: BARRIO HEALTHCARE, 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1609597335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRIO HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	3112 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1613
Country	:	US
Telephone Number	:	520-869-3565
Fax Number	:	405-297-4928

Provider Business Practice Location Address
First Line	:	3112 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1613
Country	:	US
Telephone Number	:	520-869-3565
Fax Number	:	833-471-2668

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. ANGELICA MARIA HIBBS
Credential	:	FNP
Telephone Number	:	520-869-3565

Provider Enumeration Date	:	09/09/2022
Last Update Date	:	09/30/2023

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