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NPI Code Detail

MEDICARE: PIMA PREVENTION PARTNERSHIP

MEDICARE: PIMA PREVENTION PARTNERSHIP
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
1251300000XLocal Education Agency (LEA)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1819641OTHERAZARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

General Provider Information

NPI Number : 1629300702
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIMA PREVENTION PARTNERSHIP
Provider Business Mailing Address
First Line : 3130 E BROADWAY BLVD
Second Line : SUITE 180
City : TUCSON
State : AZ
Zip : 85716-5863
Country : US
Telephone Number : 520-791-2711
Fax Number : 520-791-2202
Provider Business Practice Location Address
First Line : 1346 N STONE AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85705-7338
Country : US
Telephone Number : 520-326-2528
Fax Number : 520-326-2527
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. HARRY KRESSLER
Credential :
Telephone Number : 520-791-2711
Provider Enumeration Date : 02/01/2010
Last Update Date : 02/01/2010

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Directions to “PIMA PREVENTION PARTNERSHIP ” Practice Location

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