AJO COMMUNITY HEALTH CENTER (NPI# 1114037496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114037496 |
| Entity Type | Organization |
| Organization Name | AJO COMMUNITY HEALTH CENTER |
| Other Organization Name | DESERT SENITA COMMUNITY HEALTH CENTER |
| Practice Address |
410 N Malacate St Ajo AZ 85321-2254 |
| Practice Telephone | 5203875651 |
| Practice Fax Number | 5203875347 |
| Mailing Telephone | 5203875651 |
| Mailing Fax Number | 5203875347 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-01-07 |
| Authorized Official Name | FRAN DRIVER (CEO) |
| Authorized Official Telephone | 5203875651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC-0274 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BCBS | AZ0910930 | 01 |
| AZ | 155681 | 05 |
| Other Name | Type Code |
|---|---|
| DESERT SENITA COMMUNITY HEALTH CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548794142 | Ajo Community Health Center | Clinic/Center | 13060 S Sunland Gin Rd, Arizona City, AZ 85123 | 2017-04-20 |
| 1447388046 | Ajo Community Health Center | Dentist | 140 W Estrella Ave, Ajo, AZ 85321-2753 | 2007-03-02 |
| 1174844823 | Ajo Community Health Center | Clinic/Center | 410 N Malacate St, Ajo, AZ 85321-2254 | 2010-06-17 |
| 1164751285 | Ajo Community Health Center | Pharmacy | 410 N Malacate St, Ajo, AZ 85321-2254 | 2009-12-19 |
| Street Address |
410 N MALACATE ST |
| City | AJO |
| State | AZ |
| Zip Code | 85321-2254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528034626 | Walter R Cayce | Family Medicine | 410 N Malacate St, Ajo, AZ 85321-2254 | 2006-02-28 |
| 1851935787 | Katiria M Alvarez | Dietitian, Registered | 410 N Malacate St, Ajo, AZ 85321-2254 | 2019-11-04 |
| 1588136998 | John Charles Sauer | Family Medicine | 410 N Malacate St, Ajo, AZ 85321-2254 | 2018-12-23 |
| 1861933848 | Zachary Segerman | Pharmacist | 410 N Malacate St, Ajo, AZ 85321-2254 | 2017-03-10 |
| 1750739058 | Emily Saunders | Social Worker | 410 N Malacate St, Ajo, AZ 85321-2254 | 2016-05-26 |
| 1639560865 | Miriam Hoda | Dietitian, Registered | 410 N Malacate St, Ajo, AZ 85321-2254 | 2015-02-10 |
| 1194167973 | Linda Lucile Volin | Pharmacist | 410 N Malacate St, Ajo, AZ 85321-2254 | 2013-07-22 |
| 1093066235 | Desert Senita Pharmacy | Pharmacy | 410 N Malacate St, Ajo, AZ 85321-2254 | 2012-09-27 |
| 1114205317 | Catrina Yvette Prather | Registered Nurse | 410 N Malacate St, Ajo, AZ 85321-2254 | 2011-07-22 |
| 1174844823 | Ajo Community Health Center | Clinic/Center | 410 N Malacate St, Ajo, AZ 85321-2254 | 2010-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821276452 | Beverly Lyndele Mikus | Registered Nurse | 410 Malacate St, Ajo, AZ 85321 | 2008-02-06 |
| 1164553731 | Julie Lynn Anderson | Registered Nurse | 231 W Rocalla Ave, Ajo, AZ 85321 | 2007-03-08 |
| 1679565642 | Ajo Ambulance Inc | Ambulance | 1850 N Ajo Gila Bnd Hwy, Ajo, AZ 85321-1117 | 2005-08-16 |
| 1689239527 | Mujica Dos Fronteras | Non-emergency Medical Transport (VAN) | 110 N Highway 86, Ajo, AZ 85321-1401 | 2019-05-07 |
| 1578181855 | Sgl Counseling & Consulting | Counselor | 1341 W North St, Ajo, AZ 85321-1529 | 2020-07-13 |
| 1679728299 | Second Generation, Inc. | Non-emergency Medical Transport (VAN) | 1248 N 2nd Ave, Ajo, AZ 85321-1602 | 2008-11-24 |
| 1194872879 | Patricia Lynn Holbrook | Counselor | 310 E 2nd Ave, Ajo, AZ 85321-1812 | 2007-01-04 |
| 1871630798 | Ajo Unified School District #15 | Student in an Organized Health Care Education/Training Program | 111 N Well Rd, Ajo, AZ 85321-1840 | 2007-01-31 |
| 1245258748 | Jennifer K Lim | Dentist | 410 N Malacate St Bldg B, Desert Senita Dental Center, Ajo, AZ 85321-2254 | 2006-07-17 |
| 1023187978 | Tomar LLC | Pharmacy | 40 N Plaza St, Ajo, AZ 85321-2464 | 2006-11-07 |
| Find all providers in zip 85321 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1881198992 | Valle Del Sol, Inc. | Clinic/Center | 334 W 10th Pl Ste 100, Mesa, AZ 85201-3499 | 2018-03-22 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.