Provider Demographics
NPI:1699737023
Name:DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
Entity type:Organization
Organization Name:DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING AND BUDGET OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CPM
Authorized Official - Phone:520-295-2427
Mailing Address - Street 1:7900 S J STOCK RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-7012
Mailing Address - Country:US
Mailing Address - Phone:520-295-2427
Mailing Address - Fax:520-295-2611
Practice Address - Street 1:7900 S J STOCK RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-7012
Practice Address - Country:US
Practice Address - Phone:520-295-2550
Practice Address - Fax:520-295-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
Not Answered163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Multi-Specialty
Not Answered163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ147133-03Medicaid
AZAZ0209620OtherBCBSAZ PROV #
AZ1437157302OtherFACILITY NPI #
AZ706921-01Medicaid
AZ907008-01Medicaid
AZAZ0209620OtherBCBSAZ PROV #
AZ1437157302OtherFACILITY NPI #