1124326558 NPI number — WEST AJO MEDICAL CENTER LTD.

Table of content: NANCY DENISE HOOKS NP (NPI 1174896245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124326558 NPI number — WEST AJO MEDICAL CENTER LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST AJO MEDICAL CENTER LTD.
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:
Provider Other Organization Name Type Code:
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:
1124326558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 W AJO WAY
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:
85713-6036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-573-0993
Provider Business Mailing Address Fax Number:
520-573-0440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 W AJO WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85713-6036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-573-0993
Provider Business Practice Location Address Fax Number:
520-573-0440
Provider Enumeration Date:
03/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FRITZ
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
OWNER/SOLE PROPRIETOR
Authorized Official Telephone Number:
520-573-0993

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  1951 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10458 . This is a "PACIFICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1992894380 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0060530 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004660256 . This is a "AETNA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com