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6152 W Hardscrabble Mesa Rd Pine AZ 85544-5238 | |
(928) 596-4848 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 6152 W Hardscrabble Mesa Rd, Pine, Arizona |
Authorized Official Name and Position | Margo Karsten (DIVISION PRESIDENT) |
Authorized Official Contact | 6027474000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | 6152 W Hardscrabble Mesa Rd Pine AZ 85544-5238 Ph: (928) 596-4848 |
NPI Number | 1245940287 |
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Provider Enumeration Date | 11/30/2022 |
Last Update Date | 11/30/2022 |
Medicare PECOS PAC ID | 9537078365 |
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Medicare Enrollment ID | O20230324001850 |
Identifier | Type | State | Issuer |
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1245940287 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |