San Luis Walk-In Clinic, INC.
Clinic/Center, Rural Health in San Luis, AZ. Organization (NPI-2).
Details
- NPI
- 1104228337
- Entity type
- Organization (NPI-2)
- Legal business name
- San Luis Walk-In Clinic, INC.
- Organization subpart
- Yes
- Enumeration date
- Sep 18, 2014
- Certification date
- Sep 7, 2023
- Last updated
- Sep 7, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
1896 E Babbit LnSan Luis, AZ 85336-7820
Phone 928-722-6112 · Fax 928-722-6113
Mailing address
Po Box 617Somerton, AZ 85350-0617
Phone 928-315-7910 · Fax 928-722-6113
Authorized official
Amanda Aguirre
President & Ceo
9283157910
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Rural Health Clinic/Center providers in San Luis · All 193 providers in San Luis
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