MARIPOSA COMMUNITY HEALTH CENTER, INC; NPI #1104122563

Contact Information

MARIPOSA COMMUNITY HEALTH CENTER, INC

1835 N MASTICK WAY
NOGALES, AZ 85621-1064

Phone: 520-281-1550
Fax: 520-281-4487
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Family Medicine	207Q00000X	08	Physician/Family Practice
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Internal Medicine	207R00000X	11	Physician/Internal Medicine
Licensed Practical Nurse	164W00000X
Nurse Practitioner	363L00000X	50	Nurse Practitioner
Obstetrics & Gynecology	207V00000X	16	Physician/Obstetrics & Gynecology
Pediatrics	208000000X	37	Physician/Pediatric Medicine
Physician Assistant	363A00000X	97	Physician Assistant
Registered Nurse	163W00000X

Indicates primary specialty

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NPI Profile & details for MARIPOSA COMMUNITY HEALTH CENTER, INC

NPI # 1104122563

LBN Legal business name MARIPOSA COMMUNITY HEALTH CENTER, INC

Authorized official AMY TAYLOR - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/02/2011

Last updated 02/10/2025 - More than a year ago

Identifiers

AZ	Medicaid	931890
AZ	Other	03-1884	MEDICARE PART A GROUP #
AZ	Other	ZFQ03-1884	MEDICARE PART B GROUP #

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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MARIPOSA COMMUNITY HEALTH CENTER, INC

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NPI Profile & details for MARIPOSA COMMUNITY HEALTH CENTER, INC

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