| Canyonlands Health Care - Safford Integrated | |
|
1615 S 1st Ave Safford AZ 85546-2103 | |
| (928) 348-1708 | |
| Not Available |
| Full Name | Canyonlands Health Care - Safford Integrated |
|---|---|
| Speciality | Clinic/Center |
| Location | 1615 S 1st Ave, Safford, Arizona |
| Authorized Official Name and Position | Christopher Hansen (CEO) |
| Authorized Official Contact | 9286459675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyonlands Health Care - Safford Integrated Po Box 1625 Page AZ 86040-1625 Ph: (928) 645-9675 | Canyonlands Health Care - Safford Integrated 1615 S 1st Ave Safford AZ 85546-2103 Ph: (928) 348-1708 |
| NPI Number | 1144755182 |
|---|---|
| Provider Enumeration Date | 04/27/2017 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 4082509591 |
|---|---|
| Medicare Enrollment ID | O20170629001899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144755182 | NPI | - | NPPES |
| 1609966860 | Other | CORPORATE NPI | |
| OTC7466 | Other | AZ | STATE FACILITY LICENSE |
| 031811 | Other | CORPORATE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | OTC7466 (Arizona) | Primary |
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