| North Country Healthcare, Inc. | |
|
2650 E. Show Low Lake Rd Suite 1 Show Low AZ 85901 | |
| (928) 537-4300 | |
| (928) 537-4301 |
| Full Name | North Country Healthcare, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2650 E. Show Low Lake Rd, Show Low, Arizona |
| Authorized Official Name and Position | Anne Newland (CEO) |
| Authorized Official Contact | 9285229400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Country Healthcare, Inc. Po Box 3630 Flagstaff AZ 86003-3630 Ph: (928) 522-9400 | North Country Healthcare, Inc. 2650 E. Show Low Lake Rd Suite 1 Show Low AZ 85901 Ph: (928) 537-4300 |
| NPI Number | 1073740098 |
|---|---|
| Provider Enumeration Date | 06/17/2009 |
| Last Update Date | 06/30/2021 |
| Medicare PECOS PAC ID | 8820981053 |
|---|---|
| Medicare Enrollment ID | O20180117002093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073740098 | NPI | - | NPPES |
| 440465 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (Arizona) | Primary |
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