Kaibeto Clinic | |
Kaibeto Boarding School Dorm # 4 Kaibeto AZ 86053-2121 | |
(928) 673-3491 | |
(928) 673-3494 |
Full Name | Kaibeto Clinic |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | Kaibeto Boarding School Dorm # 4, Kaibeto, Arizona |
Authorized Official Name and Position | Elizabeth G Latham (CEO) |
Authorized Official Contact | 9286459675 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kaibeto Clinic Po Box 1625 Page AZ 86040-1625 Ph: (928) 645-9675 | Kaibeto Clinic Kaibeto Boarding School Dorm # 4 Kaibeto AZ 86053-2121 Ph: (928) 673-3491 |
NPI Number | 1568430676 |
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Provider Enumeration Date | 03/14/2006 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568430676 | NPI | - | NPPES |
432857 | Medicaid | AZ | |
594045 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Kaibeto Chapter-dental Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 Mi N Of Jct Hwy 160 &hwy 98, Kaibeto Chapter House-dental, Kaibeto, AZ 86053 Phone: 928-283-2501 Fax: 928-283-2677 | |
Kaibeto Chapter House Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 Mi N Of Jct Hwy 160 & Hwy 98, Kaibeto Chapter House, Kaibeto, AZ 86053 Phone: 928-283-2501 Fax: 928-283-2677 |