| Sjm Premier Medical Group, Llc | |
|
3131 N Country Club Rd Ste 107-108 Tucson AZ 85716-1649 | |
| (520) 372-8626 | |
| (520) 372-8456 |
| Full Name | Sjm Premier Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3131 N Country Club Rd Ste 107-108, Tucson, Arizona |
| Authorized Official Name and Position | Nora Uehara (EXECUTIVE LEADERSHIP) |
| Authorized Official Contact | 8082341094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjm Premier Medical Group, Llc 40-001 Kmehameha Highway Suite 109 Kaneohe HI 96744 Ph: (520) 372-8626 | Sjm Premier Medical Group, Llc 3131 N Country Club Rd Ste 107-108 Tucson AZ 85716-1649 Ph: (520) 372-8626 |
| NPI Number | 1518607738 |
|---|---|
| Provider Enumeration Date | 03/29/2022 |
| Last Update Date | 05/02/2022 |
| Medicare PECOS PAC ID | 9234570748 |
|---|---|
| Medicare Enrollment ID | O20240624004196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518607738 | NPI | - | NPPES |
| ========= | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Abram A Aguilar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700080900 PECOS PAC ID: 5496848012 Enrollment ID: I20070912000317 |
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