Schuk Toak District Office
Organization Active NPI Public Health or Welfare Agency · San Isidro, AZ
NPI 1124101779 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1124101779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- SCHUK TOAK DISTRICT OFFICE
- Practice address
- Hwy 86, Milepost 127
San Isidro, AZ 85634 - Phone
- (520) 295-2503
- Fax
- (520) 295-2676
- NPI assigned
- Oct 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Priscilla Whitethorne
- Title
- Service Center Director
- Phone
- (520) 295-2503
Other NPIs on the same Medicare enrollment 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050301000125 | TX | Part B Supplier - Clinic/Group Practice | 5092768663 |
Receives reassigned benefits from 353 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sells, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
Hwy 86, Milepost 127
San Isidro, AZ 85634
Mailing address
7900 S J Stock Rd
Tucson, AZ 85746-7012
Phone (520) 295-2503
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.