Provider Demographics
NPI:1811006950
Name:SOUTHERN ARIZONA VA HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:SOUTHERN ARIZONA VA HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASEMANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:520-629-1838
Mailing Address - Street 1:9051 N HARTMAN LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9051 N HARTMAN LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-9570
Practice Address - Country:US
Practice Address - Phone:520-744-4031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN043245163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty