| |
523 Rose Ln Wickenburg AZ 85390-1448 | |
(928) 668-1833 | |
(928) 684-7457 |
Full Name | |
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Speciality | Clinic/Center |
Location | 523 Rose Ln, Wickenburg, Arizona |
Authorized Official Name and Position | James Tavary (CEO) |
Authorized Official Contact | 9286845421 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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523 Rose Ln Wickenburg AZ 85390-1448 Ph: (928) 668-1833 | 523 Rose Ln Wickenburg AZ 85390-1448 Ph: (928) 668-1833 |
NPI Number | 1225274210 |
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Provider Enumeration Date | 12/23/2008 |
Last Update Date | 04/29/2019 |
Medicare PECOS PAC ID | 4981688900 |
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Medicare Enrollment ID | O20090129000198 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225274210 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | OTC4928 (Arizona) | Primary |
282NC0060X | General Acute Care Hospital - Critical Access | RGH3505 (Arizona) | Secondary |
Anu Hospitalist Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Rose Ln, Wickenburg, AZ 85390 Phone: 702-453-3799 | |
Miller Clinic Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 Savage St, Wickenburg, AZ 85390 Phone: 928-684-2425 Fax: 928-684-0387 | |