Provider Demographics
NPI:1689386260
Name:SOUTHERN ARIZONA URGENT CARE LLC
Entity Type:Organization
Organization Name:SOUTHERN ARIZONA URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-894-1718
Mailing Address - Street 1:3662 W INA RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9175 E TANQUE VERDE RD STE 187
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-8820
Practice Address - Country:US
Practice Address - Phone:520-467-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care