Provider Demographics
NPI:1003572314
Name:SAGUARO PAIN MANAGEMENT, PLLC
Entity Type:Organization
Organization Name:SAGUARO PAIN MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THIEM
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:520-990-3899
Mailing Address - Street 1:7350 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6427
Mailing Address - Country:US
Mailing Address - Phone:520-771-8389
Mailing Address - Fax:520-771-9339
Practice Address - Street 1:7350 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6427
Practice Address - Country:US
Practice Address - Phone:520-771-8389
Practice Address - Fax:520-771-9339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-10
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ373008Medicaid