Marana Health Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MARANA HEALTH CENTER, INC

Doing business as

Erickson Health Center

Practice address

6750 E Stella Rd
Tucson, AZ 85730-2202

Phone

(520) 682-4560

Fax

(520) 682-3299

NPI assigned

Dec 6, 2006

Last updated

May 28, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

MARANA HEALTH CENTER, INCAs reported in NPPES

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

Authorized official

Name

Clarence Vatne

Title

Ceo

Phone

(520) 682-4560

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Erickson Health Center Doing business as

Part of

Marana Community Clinic

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1659430874",
    "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": "520-682-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 E STELLA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857302202",
            "telephone_number": "520-682-4560",
            "fax_number": "520-682-3299"
        }
    ],
    "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": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "VATNE",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "CEO",
        "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": "Erickson Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.