Provider Demographics
NPI:1598913782
Name:CARONDELET HEART AND VASCULAR INSTITUTE
Entity Type:Organization
Organization Name:CARONDELET HEART AND VASCULAR INSTITUTE
Other - Org Name:CARONDELET HEART AND VASCULAR INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-872-7700
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 1:4888 N STONE AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5749
Practice Address - Country:US
Practice Address - Phone:520-696-2328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH-1554282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ125538Medicare PIN