Provider Demographics
NPI:1043659816
Name:ORO VALLEY HOSPITAL LLC
Entity Type:Organization
Organization Name:ORO VALLEY HOSPITAL LLC
Other - Org Name:ORO VALLEY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:PO BOX 849870
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-9870
Mailing Address - Country:US
Mailing Address - Phone:520-901-3500
Mailing Address - Fax:520-901-3525
Practice Address - Street 1:1551 E TANGERINE RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6213
Practice Address - Country:US
Practice Address - Phone:520-901-3527
Practice Address - Fax:520-901-3525
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORO VALLEY HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-14
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH3683273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
03S114Medicare Oscar/Certification