MARIPOSA COMMUNITY HEALTH CENTER INC NPI 1104122563

NPI Information

NPI: 1104122563
Provider Name: MARIPOSA COMMUNITY HEALTH CENTER, INC

Other Name: MARIPOSA MESQUITE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1835 N MASTICK WAY
NOGALES, AZ
ZIP 85621
Phone: (520) 281-1550
Get Directions

MARIPOSA COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Nogales, AZ. MARIPOSA COMMUNITY HEALTH CENTER, INC NPI is 1104122563. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Mariposa Mesquite.

The provider's business location address is:

1835 N MASTICK WAY
NOGALES, AZ
ZIP 85621-064
Phone: (520) 281-1550
Fax: (520) 281-4487

The provider's authorized official is Daniel Prevost .
The authorized official title is Chief Executive Officer and has the following contact phone number (520) 761-2128.

The enumeration date for this NPI number is 2/2/2011 and was last updated on 1/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	163W00000X	Registered Nurse		No
2	164W00000X	Licensed Practical Nurse		No
3	207Q00000X	Family Medicine		No
4	207R00000X	Internal Medicine		No
5	207V00000X	Obstetrics & Gynecology		No
6	208000000X	Pediatrics		No
7	208D00000X	General Practice		No
8	363A00000X	Physician Assistant		No
9	363L00000X	Nurse Practitioner		No
10	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZFQ03-1884	OTHER	ARIZONA	MEDICARE PART B GROUP #
2	03-1884	OTHER	ARIZONA	MEDICARE PART A GROUP #
3	931890	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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