Chilchinbeto Clinic | |
Chilchinbeto Chapter House Complex Chilchinbeto AZ 86033-1496 | |
(928) 697-8154 | |
(928) 697-8559 |
Full Name | Chilchinbeto Clinic |
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Speciality | Clinic/Center |
Location | Chilchinbeto Chapter House Complex, Chilchinbeto, 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 |
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Chilchinbeto Clinic Po Box 1625 Page AZ 86040-1625 Ph: (928) 645-9675 | Chilchinbeto Clinic Chilchinbeto Chapter House Complex Chilchinbeto AZ 86033-1496 Ph: (928) 697-8154 |
NPI Number | 1154380392 |
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Provider Enumeration Date | 03/17/2006 |
Last Update Date | 09/23/2021 |
Medicare PECOS PAC ID | 4082509591 |
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Medicare Enrollment ID | O20090303000103 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154380392 | NPI | - | NPPES |
594037 | Medicaid | AZ | |
933559 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QC1500X | Clinic/center - Community Health | (Arizona) | Primary |