Provider Demographics
NPI:1770638538
Name:SUPERSTITION MOUNTAIN ELEMENTARY SCHOOL
Entity Type:Organization
Organization Name:SUPERSTITION MOUNTAIN ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:TOMASETTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:482-982-1110
Mailing Address - Street 1:550 S IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-5002
Mailing Address - Country:US
Mailing Address - Phone:480-982-1110
Mailing Address - Fax:480-982-4978
Practice Address - Street 1:550 S IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85220-5002
Practice Address - Country:US
Practice Address - Phone:480-982-1110
Practice Address - Fax:480-982-4978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ896821390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty