Marana Health Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MARANA HEALTH CENTER, INC

Doing business as

Rita Ranch Family Health Center

Practice address

8045 S Rita Rd
Tucson, AZ 85747-9018

Phone

(520) 682-4560

Fax

(520) 682-4570

NPI assigned

Dec 6, 2006

Last updated

Dec 16, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

MARANA HEALTH CENTER, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

DD Sande

Title

Credentialing Specialist

Phone

(520) 682-4560

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rita Ranch Family Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053470294. Details of each certification follow.

• CCN 031856 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 031856

Legal name

MARANA HEALTH CENTER INC

Doing business as

SANTA CATALINA HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 23, 2007

Last certification

Mar 23, 2007

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 24, 1957 in AZ

Enrollment address

16701 N Oracle Rd 135
Tucson, AZ 85739-9102

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Marana Health Center, Inc

  dba Santa Catalina Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1750440905

  O20070205000080

  Same enrollment

Part of

Marana Community Clinic

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1053470294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4560",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 S RITA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857479018",
            "telephone_number": "520-682-4560",
            "fax_number": "520-682-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANA HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARANA HEALTH CENTER, INC.",
        "enumeration_date": "2006-12-06",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "SANDE",
        "authorized_official_first_name": "DD",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "520-682-4560"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060153",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS GROUP NUMBER",
            "identifier": "329592",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rita Ranch Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marana Health Center, Inc (Flowing Wells Family Health Center)
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• Federally Qualified Health Center (FQHC) in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Federally Qualified Health Center (FQHC) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.