Provider Demographics
NPI:1457685422
Name:SANZ INC.
Entity Type:Organization
Organization Name:SANZ INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-762-1557
Mailing Address - Street 1:13180 E COLOSSAL CAVE RD
Mailing Address - Street 2:STE 150
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-9794
Mailing Address - Country:US
Mailing Address - Phone:520-762-1557
Mailing Address - Fax:520-762-8019
Practice Address - Street 1:13180 E COLOSSAL CAVE RD
Practice Address - Street 2:STE 150
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-9794
Practice Address - Country:US
Practice Address - Phone:520-762-1557
Practice Address - Fax:520-762-8019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31208261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ695957Medicaid
AZDS3639OtherMEDICARE RR
AZH73634Medicare UPIN
AZ695957Medicaid