Provider Demographics
NPI:1194593509
Name:AZORNA HEALTHCARE TUCSON LLC
Entity type:Organization
Organization Name:AZORNA HEALTHCARE TUCSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-637-4100
Mailing Address - Street 1:5416 E BASELINE RD STE 114
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4702
Mailing Address - Country:US
Mailing Address - Phone:480-637-4100
Mailing Address - Fax:480-637-4101
Practice Address - Street 1:3275 W INA RD STE 145
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2328
Practice Address - Country:US
Practice Address - Phone:520-965-0300
Practice Address - Fax:520-965-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based