Provider Demographics
NPI:1154442796
Name:MEDASSURE OF TUCSON, INC
Entity Type:Organization
Organization Name:MEDASSURE OF TUCSON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRETE
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:520-884-9484
Mailing Address - Street 1:1955 W GRANT RD STE 235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1479
Mailing Address - Country:US
Mailing Address - Phone:520-884-9484
Mailing Address - Fax:520-884-9003
Practice Address - Street 1:1955 W GRANT RD # 235
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-884-9484
Practice Address - Fax:520-884-9003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10-197117-Y332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4371320001Medicare NSC