Provider Demographics
NPI:1609447903
Name:EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Entity Type:Organization
Organization Name:EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELVA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-670-3813
Mailing Address - Street 1:PO BOX 1231
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85702-1231
Mailing Address - Country:US
Mailing Address - Phone:520-670-3813
Mailing Address - Fax:
Practice Address - Street 1:3655 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2933
Practice Address - Country:US
Practice Address - Phone:520-670-3813
Practice Address - Fax:520-670-7560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy