ST ELIZABETHS HEALTH CENTER INC; NPI #1023409760

Contact Information

ST ELIZABETHS HEALTH CENTER INC

140 W SPEEDWAY BLVD
STE #100
TUCSON, AZ 85705-7686

Phone: 520-628-7871
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for ST ELIZABETHS HEALTH CENTER INC

NPI # 1023409760

LBN Legal business name ST ELIZABETHS HEALTH CENTER INC

Authorized official MAURICETTE MONTREDON - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/17/2015

Last updated 12/11/2019 - About 6 years ago

Identifiers

AZ	License #	OTC0037
AZ	Medicaid	939173

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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