|
| |
|
3003 Highway 95 Suite 35 Bullhead City AZ 86442-7896 | |
| (928) 704-0400 | |
| (928) 704-0400 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 3003 Highway 95, Bullhead City, Arizona |
| Authorized Official Name and Position | Kamilia Banoub (PRESIDENT) |
| Authorized Official Contact | 9287040400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3003 Highway 95 Suite 35 Bullhead City AZ 86442-7896 Ph: (928) 704-0400 | 3003 Highway 95 Suite 35 Bullhead City AZ 86442-7896 Ph: (928) 704-0400 |
| NPI Number | 1912334988 |
|---|---|
| Provider Enumeration Date | 10/04/2013 |
| Last Update Date | 06/05/2023 |
| Medicare PECOS PAC ID | 9931322708 |
|---|---|
| Medicare Enrollment ID | O20140523000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912334988 | NPI | - | NPPES |
| 443324 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25571 (Arizona) | Primary |
| Provider Name | Sonia S Giknavorian |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1225132608 PECOS PAC ID: 8921026113 Enrollment ID: I20051107000147 |
| Provider Name | Bhavani Naginani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669702155 PECOS PAC ID: 4587709571 Enrollment ID: I20100922000305 |
| Provider Name | Kelly Lapa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255856803 PECOS PAC ID: 6305103797 Enrollment ID: I20171120000626 |
| Provider Name | Shannon Janine Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275164337 PECOS PAC ID: 3173951456 Enrollment ID: I20200319002854 |
| Provider Name | Rachel L Bardos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265003081 PECOS PAC ID: 4385049360 Enrollment ID: I20210830001975 |
| Provider Name | Megan Anne Lynch |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043037427 PECOS PAC ID: 0648704437 Enrollment ID: I20241115003017 |
Beneze Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3003 Highway 95, Suite G73, Bullhead City, AZ 86442 Phone: 928-758-7700 Fax: 928-758-5700 | |
River Cities Community Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 813 Hancock Rd, Suite 2, Bullhead City, AZ 86442 Phone: 928-704-9700 | |
All Wellness Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Canyon Rd Ste A1, Bullhead City, AZ 86442 Phone: 928-704-4499 Fax: 928-704-4949 | |
All Women's Regional Medical Center, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Canyon Rd, Ste A1, Bullhead City, AZ 86442 Phone: 928-704-4499 Fax: 928-704-4949 | |
Dadra Hospital Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3706 Highway 95 Ste 101, Bullhead City, AZ 86442 Phone: 928-201-9286 Fax: 928-219-4610 | |
Jr Renaissance Health Services, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1957 Hway 95 Ste 23, Bullhead City, AZ 86442 Phone: 928-234-3834 |