Provider Demographics
NPI:1104887199
Name:UNIVERSITY PHYSICIANS HEALTHCARE
Entity type:Organization
Organization Name:UNIVERSITY PHYSICIANS HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS OPERATIONS AND SPECIAL PR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOTISKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-874-2863
Mailing Address - Street 1:2701 E ELVIRA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706-7124
Mailing Address - Country:US
Mailing Address - Phone:520-874-4135
Mailing Address - Fax:520-874-7048
Practice Address - Street 1:2800 E AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-874-4135
Practice Address - Fax:520-874-7048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH3577282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ28426824OtherOTHER
AZ874223Medicaid
AZAZ0209370OtherBLUE CROSS BLUE SHIELD
CAXHSP43804OtherMEDICAL
AZ89229860Medicaid
AZ0087422301Medicaid
AZ2Z3934OtherHEALTHNET
AZAW6912OtherHEALTHNET
AZDC6028OtherRAILROAD MEDICARE
AZ5080282OtherEVERCARE
AZ600947200OtherBILLING
AZ600947200OtherBILLING
AZAW6912OtherHEALTHNET