Provider Demographics
NPI:1487014882
Name:SMSJ TUCSON HOLDINGS, LLC
Entity Type:Organization
Organization Name:SMSJ TUCSON HOLDINGS, LLC
Other - Org Name:ST. MARY'S HOSPITAL MEDICAL MALL AT GREEN VALLEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-747-2634
Mailing Address - Street 1:395 N SILVERBELL RD
Mailing Address - Street 2:SUITE 185
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2675
Mailing Address - Country:US
Mailing Address - Phone:520-609-2509
Mailing Address - Fax:
Practice Address - Street 1:400 W CAMINO CASA VERDE
Practice Address - Street 2:SUITE 200
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-3564
Practice Address - Country:US
Practice Address - Phone:520-872-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty