| Sanders Clinic | |
|
Rio Vista Estates Lot #24 Sanders AZ 86512 | |
| (928) 688-3903 | |
| (928) 688-4471 |
| Full Name | Sanders Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | Rio Vista Estates Lot #24, Sanders, Arizona |
| Authorized Official Name and Position | Vanessa Marie Begay (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9286883903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanders Clinic Po Box 489 Sanders AZ 86512 Ph: (928) 688-3903 | Sanders Clinic Rio Vista Estates Lot #24 Sanders AZ 86512 Ph: (928) 688-3903 |
| NPI Number | 1235238700 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 11/20/2023 |
| Medicare PECOS PAC ID | 3870591233 |
|---|---|
| Medicare Enrollment ID | O20100202000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235238700 | NPI | - | NPPES |
| 191513 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OTC3822 (Arizona) | Primary |
| Provider Name | Heidi A Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982952065 PECOS PAC ID: 7719137660 Enrollment ID: I20121030000455 |
| Provider Name | Mary Elizabeth Braham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508176694 PECOS PAC ID: 9638497944 Enrollment ID: I20150417000595 |
| Provider Name | Lorraine D Kelwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053675934 PECOS PAC ID: 7719133511 Enrollment ID: I20160513000951 |
| Provider Name | Catherine Diane Torres |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1013017961 PECOS PAC ID: 6002243417 Enrollment ID: I20200225001319 |
Sanders Clinic Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Park Estates #49 Sun Lane, Sanders, AZ 86512 Phone: 928-688-3903 Fax: 928-688-4471 |