Provider Demographics
NPI:1952672271
Name:THE UNIVERSITY OF ARIZONA, CAMPUS HEALTH SERVICE
Entity Type:Organization
Organization Name:THE UNIVERSITY OF ARIZONA, CAMPUS HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, ADMINISTRATIVE SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:KREUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:520-621-4199
Mailing Address - Street 1:1224 E LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0095
Mailing Address - Country:US
Mailing Address - Phone:520-621-6490
Mailing Address - Fax:520-621-8412
Practice Address - Street 1:1224 E LOWELL ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0095
Practice Address - Country:US
Practice Address - Phone:520-621-6490
Practice Address - Fax:520-621-8412
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE UNIVERSITY OF ARIZONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC3502261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health