| Copper Mountain Clinic | |
|
2250 W 16th St Safford AZ 85546-4081 | |
| (928) 348-4037 | |
| (844) 271-2379 |
| Full Name | Copper Mountain Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2250 W 16th St, Safford, Arizona |
| Authorized Official Name and Position | Diane Hansen (DIRECTOR OUTPATIENT CLINICS) |
| Authorized Official Contact | 9283484037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Mountain Clinic 2250 W 16th St Safford AZ 85546-4081 Ph: (928) 348-4037 | Copper Mountain Clinic 2250 W 16th St Safford AZ 85546-4081 Ph: (928) 348-4037 |
| NPI Number | 1346528759 |
|---|---|
| Provider Enumeration Date | 08/02/2011 |
| Last Update Date | 03/24/2016 |
| Medicare PECOS PAC ID | 6204822364 |
|---|---|
| Medicare Enrollment ID | O20120620000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346528759 | NPI | - | NPPES |
| 920739 | Medicaid | AZ | |
| 964830 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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