Provider Demographics
NPI:1952442402
Name:PIMA PATHOLOGISTS, PC
Entity Type:Organization
Organization Name:PIMA PATHOLOGISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:STROHM
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:520-884-0921
Mailing Address - Street 1:PO BOX 2288
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-2288
Mailing Address - Country:US
Mailing Address - Phone:520-884-0921
Mailing Address - Fax:520-884-7670
Practice Address - Street 1:1601 W ST MARY'S ROAD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-872-6032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCGDGMedicare ID - Type UnspecifiedNORIDIAN MEDICARE