Provider Demographics
NPI:1912336538
Name:THE UNIVERSITY OF ARIZONA
Entity Type:Organization
Organization Name:THE UNIVERSITY OF ARIZONA
Other - Org Name:ARIZONA POISON AND DRUG INFORMATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOESEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:520-626-6230
Mailing Address - Street 1:1295 N MARTIN AVENUE
Mailing Address - Street 2:DRACHMAN HALL ROOM B308
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0202
Mailing Address - Country:US
Mailing Address - Phone:520-626-6230
Mailing Address - Fax:
Practice Address - Street 1:1295 N MARTIN AVENUE
Practice Address - Street 2:DRACHMAN HALL ROOM B308
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0202
Practice Address - Country:US
Practice Address - Phone:520-626-6230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service