Provider Demographics
NPI:1790901106
Name:PINAL COUNTY PUBLIC HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:PINAL COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZARRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-866-7319
Mailing Address - Street 1:PO BOX 2945
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85232-2945
Mailing Address - Country:US
Mailing Address - Phone:520-866-7319
Mailing Address - Fax:520-866-7358
Practice Address - Street 1:500 S. CENTRAL
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85232
Practice Address - Country:US
Practice Address - Phone:520-866-7319
Practice Address - Fax:520-866-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ527450Medicaid
AZ527450Medicaid
H30320Medicare UPIN