| Wide Ruins Clinic | |
|
Arizona Highway 191 Ganado AZ 86505-0457 | |
| (928) 755-4500 | |
| (928) 755-4659 |
| Full Name | Wide Ruins Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | Arizona Highway 191, Ganado, Arizona |
| Authorized Official Name and Position | Todd Mitchell Mcgee (CFO) |
| Authorized Official Contact | 9287554500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wide Ruins Clinic Po Box 457 Ganado AZ 86505-0457 Ph: (928) 755-4500 | Wide Ruins Clinic Arizona Highway 191 Ganado AZ 86505-0457 Ph: (928) 755-4500 |
| NPI Number | 1104043926 |
|---|---|
| Provider Enumeration Date | 04/20/2007 |
| Last Update Date | 09/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104043926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | RGH3899 (Arizona) | Primary |
Greasewood Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Navajo Route 15, Ganado, AZ 86505 Phone: 928-755-4500 Fax: 928-755-4659 | |
Sage Outpatient Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Arizona Highway 264 & Junction 191, Ganado, AZ 86505 Phone: 928-755-4500 Fax: 928-755-4659 |