NPIMap

Organization Active NPI

San Luis Walk-in Clinic, Inc.

  • Infusion Therapy Clinic/Center
  • San Luis, AZ
National Provider Identifier
1144916552
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
SAN LUIS WALK-IN CLINIC, INC.
Practice address
151 S Oak Ave Ste 6
San Luis, AZ 85336-0756
Phone
(928) 662-0409
Fax
(928) 662-0410
NPI assigned
Apr 18, 2023
Organization subpart
Yes
Parent organization
SAN LUIS WALK-IN CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Amanda Aguirre
Title
President & Ceo
Phone
(928) 315-7910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

151 S Oak Ave Ste 6
San Luis, AZ 85336-0756

Mailing address

PO Box 617
Somerton, AZ 85350-0617
Phone (928) 276-3414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040514000795 AZ Part B Supplier - Clinic/Group Practice 2668361841 Receives reassigned benefits from 88 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Somerton, AZ; Yuma, AZ; San Luis, AZ; Kingman, AZ; Parker, AZ; Lake Havasu City, AZ

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Tax ID family
San Luis Walk-in Clinic Inc20 organizations share this tax ID, including this one
Part of
San Luis Walk-in Clinic Inc

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1144916552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-276-3414",
            "fax_number": "928-276-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 S OAK AVE STE 6",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853360756",
            "telephone_number": "928-662-0409",
            "fax_number": "928-662-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS WALK-IN CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN LUIS WALK-IN CLINIC, INC.",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "928-315-7910"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.