Provider Demographics
NPI:1487652426
Name:TON SELLS HOSPITAL
Entity Type:Organization
Organization Name:TON SELLS HOSPITAL
Other - Org Name:SELLS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-383-7285
Mailing Address - Street 1:7900 S J STOCK RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-7012
Mailing Address - Country:US
Mailing Address - Phone:520-295-2546
Mailing Address - Fax:520-295-2676
Practice Address - Street 1:HIGHWAY 86 AT TOPAWA ROAD
Practice Address - Street 2:
Practice Address - City:SELLS
Practice Address - State:AZ
Practice Address - Zip Code:85634-0548
Practice Address - Country:US
Practice Address - Phone:520-383-7251
Practice Address - Fax:520-383-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020579-03Medicaid
AZ706921-01Medicaid
AZ03D0531947OtherCLIA #
AZAZ0209580OtherBC/BSAZ PROV NO
AZ0325642OtherNACADP#
AZAC0015OtherASC
AZHSZ170Medicare Oscar/Certification
AZ5830760001Medicare NSC
AZ030074Medicare Oscar/Certification