NPIMap

Organization Active NPI

State of Arizona

Doing business as U of College of Phcy

  • Clinic Pharmacy
  • Tucson, AZ
National Provider Identifier
1730295684
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
1700 Issued in AZ
Legal business name
STATE OF ARIZONA
Doing business as
U of College of Phcy
Practice address
1295 N Martin
Tucson, AZ 85721-0001
Phone
(520) 626-3981
Fax
(520) 626-6026
NPI assigned
Aug 22, 2006
Last updated
Jan 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Kevin BoesenNPI 1679557607
Title
Dir Medication Mngmnt CNTR
Phone
(520) 626-3981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 1700 AZ Primary

Addresses

Primary practice location

1295 N Martin
Tucson, AZ 85721-0001

Mailing address

PO Box 210602
Tucson, AZ 85721-0001
Phone (520) 626-3981

Other identifiers 1

IdentifierTypeStateIssuer
0314067OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • U OF COLLEGE OF PHCY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Arizona Mental32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1730295684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210602",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857210001",
            "telephone_number": "520-626-3981",
            "fax_number": "520-626-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 N MARTIN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857210001",
            "telephone_number": "520-626-3981",
            "fax_number": "520-626-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "BOESEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIR MEDICATION MNGMNT CNTR",
        "authorized_official_telephone_number": "520-626-3981"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "AZ",
            "license": "1700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0314067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U OF COLLEGE OF PHCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.