Provider Demographics
NPI:1932496049
Name:UNIVERSITY OF ARIZONA
Entity Type:Organization
Organization Name:UNIVERSITY OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-626-4657
Mailing Address - Street 1:1501 N CAMPBELL AVE RM 3335
Mailing Address - Street 2:P.O. BOX 245073
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-3450
Mailing Address - Country:US
Mailing Address - Phone:520-626-4657
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE RM 3335
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-3450
Practice Address - Country:US
Practice Address - Phone:541-790-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR72586282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren