Provider Demographics
NPI:1275519241
Name:EL RIO HEALTH CENTER (SOUTHWEST)
Entity type:Organization
Organization Name:EL RIO HEALTH CENTER (SOUTHWEST)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:G
Authorized Official - Last Name:KUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-601-0607
Mailing Address - Street 1:1510 W COMMERCE COURT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-6015
Mailing Address - Country:US
Mailing Address - Phone:520-434-0678
Mailing Address - Fax:520-806-2631
Practice Address - Street 1:1510 W COMMERCE COURT
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6015
Practice Address - Country:US
Practice Address - Phone:520-434-0678
Practice Address - Fax:520-806-2631
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-21
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy