Pinal Hispanic Council Incorporated
Organization Active NPI Community/Behavioral Health Agency · Bisbee, AZ
NPI 1104669720 · NPPES record last updated Oct 27, 2025
Key facts
- NPI
- 1104669720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- PINAL HISPANIC COUNCIL INCORPORATED
- Practice address
- 1326 W Highway 92 Ste J
Bisbee, AZ 85603-1151 - Phone
- (520) 366-3603
- Fax
- (520) 432-3678
- NPI assigned
- Jun 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Rose M Lopez, MBA
- Title
- President and Ceo
- Phone
- (520) 721-1887
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 9
Practitioners 1
-
Alaina Martinez, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091104000052 | AZ | Part B Supplier - Clinic/Group Practice | 4981742434 |
Receives reassigned benefits from 31 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tucson, AZ; Phoenix, AZ; Nogales, AZ; Eloy, AZ; Douglas, AZ; Coolidge, AZ; Casa Grande, AZ; Bisbee, AZ |
National Provider Directory
- Tax ID family
- Pinal Hispanic Council
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
1326 W Highway 92 Ste J
Bisbee, AZ 85603-1151
Mailing address
PO Box 86537
Tucson, AZ 85754-6537
Phone (520) 721-1887
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH4287 | Other | AZ | BUREAU OF MEDICAL FACILITIES LICENSING |
Other names
- Community Health Associates, Inc.
Other providers in Bisbee, AZ
- Nicholas Elias Night I
- Natachi Maresya Onwudiwe
- Nosakhare Emmanuel Osa-Edoh
- Carole Parent
- Marlyne Perez
- Ludovit Reuben Prikler
- Candace Lynne Quibell
- Jean Marie Robidoux
- Denise Michelle Rogers
- Hadi Safavi
All providers in Bisbee, AZ · Community/Behavioral Health Agency in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.