Optima Medical

LBN: Old Pueblo Healthcare Llc
Optima Medical is an health care organization with primary practice located at 5981 E Grant Rd Suite 115, Tucson AZ 85712. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as the primary health care specialty. Old Pueblo Healthcare Llc can be contacted via phone (520) 886-5315, or through O'Neil, Michael via phone (480) 660-6706.

Contact Information

Primary practice address
5981 E Grant Rd Suite 115 Tucson AZ 85712
Phone: (520) 886-5315
Fax: (520) 298-8201
Website:
Map and Directions
Authorized official contact:
Name: O'Neil, Michael
Phone: (480) 660-6706

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN069526 Arizona

Profile Details

NPI number 1306890793
LBN Legal business name Old Pueblo Healthcare Llc
DBA Doing business as Optima Medical
Authorized official O'Neil, Michael
Entity Organization
Organization subpart 1 No
Enumeration date May 20th, 2006
Last updated Jun 15th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306890793 NPPES
Arizona MEDICAID 101738

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