Provider Demographics
NPI:1730732074
Name:NEXTGEN TOTAL CARE LLC
Entity type:Organization
Organization Name:NEXTGEN TOTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-377-2706
Mailing Address - Street 1:PO BOX 64636
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85728-4636
Mailing Address - Country:US
Mailing Address - Phone:520-975-3119
Mailing Address - Fax:520-844-1522
Practice Address - Street 1:437 W THURBER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-6822
Practice Address - Country:US
Practice Address - Phone:520-975-3119
Practice Address - Fax:520-844-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty