| Portable Practical Education Preparation Inc. | |
|
111 La Mina Ave Room 5 Ajo AZ 85321-2716 | |
| (520) 387-5232 | |
| (520) 387-5732 |
| Full Name | Portable Practical Education Preparation Inc. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 111 La Mina Ave, Ajo, Arizona |
| Authorized Official Name and Position | John David Arnold (CEO/FOUNDER) |
| Authorized Official Contact | 5206223553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portable Practical Education Preparation Inc. 802 E 46th St Tucson AZ 85713-5006 Ph: (520) 622-3553 | Portable Practical Education Preparation Inc. 111 La Mina Ave Room 5 Ajo AZ 85321-2716 Ph: (520) 387-5232 |
| NPI Number | 1215034590 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215034590 | NPI | - | NPPES |
| 134966 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | BH387 (Arizona) | Primary |
Desert Senita Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 N Malacate St, Ajo, AZ 85321 Phone: 520-387-5651 Fax: 520-387-5347 |