Provider Demographics
NPI:1427195163
Name:CARONDELET HEALTH NETWORK
Entity Type:Organization
Organization Name:CARONDELET HEALTH NETWORK
Other - Org Name:CARONDELET REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:R
Authorized Official - Last Name:PEPPING
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:520-872-7790
Mailing Address - Street 1:2202 N FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1412
Mailing Address - Country:US
Mailing Address - Phone:520-872-7700
Mailing Address - Fax:
Practice Address - Street 1:1055 NORTH LACANADA
Practice Address - Street 2:SUITE 103
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3564
Practice Address - Country:US
Practice Address - Phone:520-648-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH0011261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ030010Medicare ID - Type UnspecifiedGREEN VALLEY REHAB SVCS