Provider Demographics
NPI:1073376281
Name:PIMA COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:PIMA COUNTY HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:COCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-724-7742
Mailing Address - Street 1:3950 S COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-2099
Mailing Address - Country:US
Mailing Address - Phone:207-247-7425
Mailing Address - Fax:
Practice Address - Street 1:6920 E BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2839
Practice Address - Country:US
Practice Address - Phone:520-724-9650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIMA COUNTY HEALTH DEPT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty