Provider Demographics
NPI:1962259812
Name:PIMA HEART PHYSICIANS, PC
Entity type:Organization
Organization Name:PIMA HEART PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:MARCELLA
Authorized Official - Last Name:RASNAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-838-2411
Mailing Address - Street 1:555 E RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5843
Mailing Address - Country:US
Mailing Address - Phone:520-838-3540
Mailing Address - Fax:520-325-3526
Practice Address - Street 1:4475 S I 19 FRONTAGE RD STE 125
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-6336
Practice Address - Country:US
Practice Address - Phone:520-838-3540
Practice Address - Fax:520-325-3526
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIMA HEART PHYSICIANS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Multi-Specialty