Provider Demographics
NPI:1326712274
Name:PALOVERDE HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:PALOVERDE HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULL
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:928-485-5353
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:PIMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85543-0009
Mailing Address - Country:US
Mailing Address - Phone:928-485-5353
Mailing Address - Fax:928-485-4545
Practice Address - Street 1:18 W CENTER ST
Practice Address - Street 2:
Practice Address - City:PIMA
Practice Address - State:AZ
Practice Address - Zip Code:85543-0030
Practice Address - Country:US
Practice Address - Phone:928-485-5353
Practice Address - Fax:928-485-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty