1801345004 NPI number — UNIVERSITY OF ARIZONA NURSING AND HEALTH ASSOCIATES

Table of content: (NPI 1801345004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801345004 NPI number — UNIVERSITY OF ARIZONA NURSING AND HEALTH ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF ARIZONA NURSING AND HEALTH ASSOCIATES
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:
1801345004
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1305 N MARTIN AVE
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:
85721-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-626-6154
Provider Business Mailing Address Fax Number:
520-626-6424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1305 N MARTIN AVE
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:
85721-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-626-6154
Provider Business Practice Location Address Fax Number:
520-626-6424
Provider Enumeration Date:
09/28/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PRETTYMAN
Authorized Official First Name:
ALLEN
Authorized Official Middle Name:
VAUGHAN
Authorized Official Title or Position:
DIRECTOR OF PRACTICE INNOVATIONS
Authorized Official Telephone Number:
520-621-1995

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP7965 , 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)