| Canyonlands Community Health Care | |
|
10 Ward Canyon Road #a Clifton AZ 85533 | |
| (928) 645-9675 | |
| Not Available |
| Full Name | Canyonlands Community Health Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Ward Canyon Road, Clifton, Arizona |
| Authorized Official Name and Position | Christopher J Hansen (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9286459675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyonlands Community Health Care Po Box 1625 827 Vista Ave Page AZ 86040-1625 Ph: (928) 645-9675 | Canyonlands Community Health Care 10 Ward Canyon Road #a Clifton AZ 85533 Ph: (928) 645-9675 |
| NPI Number | 1134568660 |
|---|---|
| Provider Enumeration Date | 06/18/2013 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 4082509591 |
|---|---|
| Medicare Enrollment ID | O20141205000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134568660 | NPI | - | NPPES |
| 031811 | Other | AZ | CORPORATE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |