Provider Demographics
NPI:1174512792
Name:TUCSON MEDICAL CENTER
Entity type:Organization
Organization Name:TUCSON MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SR VP - CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATE
Authorized Official - Middle Name:
Authorized Official - Last Name:TANPIENGCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-324-1160
Mailing Address - Street 1:PO BOX 31267
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:520-324-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0700X
AZH-0012282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ020462Medicaid
AZ030006Medicare ID - Type Unspecified
AZ020462Medicaid