ICE HEALTH SERVICE CORPS (NPI# 1841634201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841634201 |
| Entity Type | Organization |
| Organization Name | ICE HEALTH SERVICE CORPS |
| Practice Address |
3250 N Pinal Pkwy Florence AZ 85132-9459 |
| Practice Telephone | 5208682049 |
| Practice Fax Number | 5208681547 |
| Mailing Telephone | 5208682049 |
| Mailing Fax Number | 5208681547 |
| Enumeration Date | 2013-04-28 |
| Last Update Date | 2013-04-28 |
| Authorized Official Name | BRENT STEPHEN (HEALTH SERVICE ADMINISTRATOR) |
| Authorized Official Telephone | 5208688439 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
0024169459 | VA | Ambulatory Health Care Facilities |
| Street Address |
3250 N PINAL PKWY |
| City | FLORENCE |
| State | AZ |
| Zip Code | 85132-9459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932143617 | Roy Grando | Psychologist | 3250 N Pinal Pkwy, Medical Unit, Florence, AZ 85132-9459 | 2006-06-15 |
| 1649610411 | Monica Morris | Nurse Practitioner | 3250 N Pinal Pkwy, Florence, AZ 85132-9459 | 2013-06-26 |
| 1306280680 | Curtis D Spann | Dentist | 3250 N Pinal Pkwy, Florence, AZ 85132-9459 | 2013-04-17 |
| 1669667168 | Gina C. Tomkus | Dietitian, Registered | 3250 N Pinal Pkwy, Florence, AZ 85132-9459 | 2007-09-09 |
| 1265643159 | Orville Donald Brown IIi | Pharmacist | 3250 N Pinal Pkwy, Phs Medical Clinic, Florence, AZ 85232-9459 | 2007-05-24 |
| 1891905931 | Mel Tempel | Pharmacist | 3250 N Pinal Pkwy, Florence, AZ 85232-9459 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457905648 | Katherine Gastelum | Specialist/Technologist | 2700 North Anthem Way, Florence, AZ 85132 | 2019-07-26 |
| 1003309238 | Horizon Health and Wellness, Inc. | Clinic/Center | 450 W Adamsville Rd Ste B, Florence, AZ 85132 | 2018-06-12 |
| 1821594136 | Jeremiah David Johnson | Internal Medicine | 971 N. Jason Lopez Circle Bldg B, Florence, AZ 85132 | 2018-04-04 |
| 1174022990 | Nicholas Ryan Bibeau | Physical Therapist | 4374 East Butte Avenue, Florence, AZ 85132 | 2018-02-07 |
| 1598289464 | Cyrus Faramroze Austin | Dentist | 1100 Bowling Rd., Florence, AZ 85132 | 2017-08-01 |
| 1477082642 | Horizon Health and Wellness, Inc. | Clinic/Center | 450 W Adamsville Rd Ste A, Florence, AZ 85132 | 2017-06-09 |
| 1083150205 | Sanna Neff | Nurse Practitioner | 495 N Pinal Pkwy Ste 106, Florence, AZ 85132 | 2017-01-11 |
| 1114322807 | Affinity Physical Therapy, LLC | Physical Therapist | 350 S Main Street, Florence, AZ 85132 | 2014-10-24 |
| 1083018923 | Ryan William Taylor | Nurse Practitioner | 1155 N. Pinal Parkway, Central Az Detention Center, Florence, AZ 85132 | 2014-10-21 |
| 1881012755 | Carlos Lavor Weekly | Dentist | 1305 East Butte, Florence, AZ 85132 | 2014-03-28 |
| Find all providers in zip 85132 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699079269 | Winslow Indian Health Care Center, Inc | Clinic/Center | 1527 N Park Dr, Winslow, AZ 86047-2517 | 2010-12-22 |
| 1306016126 | Winslow Indian Health Care Center, Inc | Clinic/Center | 3 Mls S of Dilkon Chapter House, Dilkon, AZ 86047-0000 | 2008-03-07 |
| 1184729493 | Winslow Indian Health Care Center, Inc | Clinic/Center | 500 N Indiana Ave, Winslow, AZ 86047-2169 | 2006-09-13 |
| 1336199199 | Dhhs-phs, Ihs Tucson Area, Ihs Tucson | Clinic/Center | Federal Route 21, Pisinemo Village, AZ 89563 | 2006-05-11 |
| 1437157302 | Ton San Xavier Health Center | Clinic/Center | 7900 S J Stock Rd, Tucson, AZ 85746-7012 | 2005-07-13 |
| 1326491846 | Physiotherapy Associates | Clinic/Center | 9917 N 95th St, Scottsdale, AZ 85258-4586 | 2016-07-20 |
| 1023378825 | Peach Springs Indian Health Center | Clinic/Center | 943 Hualapai Way, Peach Springs, AZ 86434-0190 | 2012-05-25 |
| 1205193893 | Federal Correctional Institution | Clinic/Center | 37900 N 45th Ave Dept 1680, Phoenix, AZ 85086-7008 | 2012-04-19 |
| 1760652580 | Winslow Indian Health Care Center, Inc | Clinic/Center | 1.5 Mile N of Leupp Chapter House, Leupp, AZ 86035-0000 | 2008-03-07 |
Please comment or provide details below to improve the information on ICE HEALTH SERVICE CORPS.
| 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.