Provider Demographics
NPI:1851146427
Name:PIMA COUNTY
Entity Type:Organization
Organization Name:PIMA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:COCROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-724-7742
Mailing Address - Street 1:3950 S COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-2099
Mailing Address - Country:US
Mailing Address - Phone:520-724-7742
Mailing Address - Fax:
Practice Address - Street 1:3950 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2099
Practice Address - Country:US
Practice Address - Phone:520-724-7742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty