1487652426 NPI number — TON SELLS HOSPITAL

Table of content: (NPI 1487652426)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487652426 NPI number — TON SELLS HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TON SELLS HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SELLS HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487652426
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7900 S J STOCK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85746-7012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-295-2546
Provider Business Mailing Address Fax Number:
520-295-2676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIGHWAY 86 AT TOPAWA ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SELLS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85634-0548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-383-7251
Provider Business Practice Location Address Fax Number:
520-383-7216
Provider Enumeration Date:
07/13/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHANLEY
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPUTY CEO
Authorized Official Telephone Number:
520-383-7285

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 020579-03 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 706921-01 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03D0531947 . This is a "CLIA #" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0209580 . This is a "BC/BSAZ PROV NO" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 0325642 . This is a "NACADP#" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AC0015 . This is a "ASC" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".