Provider Demographics
NPI:1750600672
Name:DANVILLE CHILDREN'S MEDICAL CENTER
Entity type:Organization
Organization Name:DANVILLE CHILDREN'S MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOOLSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-565-0700
Mailing Address - Street 1:1400 N. WILMOT RD.
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-631-3889
Mailing Address - Fax:520-320-0658
Practice Address - Street 1:1400 N WILMOT RD
Practice Address - Street 2:SUITE # 300
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4498
Practice Address - Country:US
Practice Address - Phone:520-631-3889
Practice Address - Fax:520-320-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital