| Ice Health Service Corps | |
|
3250 N Pinal Pkwy Florence AZ 85132-9459 | |
| (520) 868-2049 | |
| (520) 868-1547 |
| Full Name | Ice Health Service Corps |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 3250 N Pinal Pkwy, Florence, Arizona |
| Authorized Official Name and Position | Brent Stephen (HEALTH SERVICE ADMINISTRATOR) |
| Authorized Official Contact | 5208688439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ice Health Service Corps 3250 N Pinal Pkwy Florence AZ 85132-9459 Ph: (520) 868-2049 | Ice Health Service Corps 3250 N Pinal Pkwy Florence AZ 85132-9459 Ph: (520) 868-2049 |
| NPI Number | 1841634201 |
|---|---|
| Provider Enumeration Date | 04/28/2013 |
| Last Update Date | 04/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841634201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | 0024169459 (Virginia) | Primary |
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