North Country Healthcare, Inc. | |
2090 N. Smoketree Ave Lake Havasu City AZ 86403 | |
(928) 854-1800 | |
(928) 854-1818 |
Full Name | North Country Healthcare, Inc. |
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Speciality | Clinic/Center |
Location | 2090 N. Smoketree Ave, Lake Havasu City, Arizona |
Authorized Official Name and Position | Anne M Newland (CEO) |
Authorized Official Contact | 9285229400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
North Country Healthcare, Inc. Po Box 3630 Flagstaff AZ 86003-3630 Ph: (928) 522-9400 | North Country Healthcare, Inc. 2090 N. Smoketree Ave Lake Havasu City AZ 86403 Ph: (928) 854-1800 |
NPI Number | 1033359468 |
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Provider Enumeration Date | 02/25/2009 |
Last Update Date | 06/30/2021 |
Medicare PECOS PAC ID | 8820981053 |
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Medicare Enrollment ID | O20090511000300 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033359468 | NPI | - | NPPES |
433079 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (Arizona) | Primary |
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