NPIMap

Organization Active NPI

Pascua Yaqui Tribe

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Tucson, AZ
National Provider Identifier
1730826355
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
PASCUA YAQUI TRIBE
Practice address
4567 W Tetakusim Rd
Tucson, AZ 85746-9713
Phone
(520) 879-6373
NPI assigned
May 16, 2022
Organization subpart
Yes
Parent organization
PASCUA YAQUI TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Linda Guerrero
Title
Delegated Official
Phone
(520) 879-6039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

4567 W Tetakusim Rd
Tucson, AZ 85746-9713

Mailing address

7490 S Camino de Oeste
Tucson, AZ 85746-9308
Phone (512) 879-6000

Other identifiers 1

IdentifierTypeStateIssuer
570192MedicaidAZ

Other names 1

  • Pascua Yaqui Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230810000268 AZ DME Supplier - Pharmacy 7618033598 Practice locations: Tucson, AZ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Pascua Yaqui Tribe21 organizations share this tax ID, including this one
Part of
Pascua Yaqui Tribe

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1730826355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7490 S CAMINO DE OESTE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857469308",
            "telephone_number": "512-879-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4567 W TETAKUSIM RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857469713",
            "telephone_number": "520-879-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASCUA YAQUI TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PASCUA YAQUI TRIBE",
        "enumeration_date": "2022-05-16",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "GUERRERO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "520-879-6039"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570192",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pascua Yaqui Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pascua Yaqui Pharmacy",
            "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 Jun 27, 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.