Healthcare Provider Details

I. General information

NPI: 1336118322
Provider Name (Legal Business Name): BENSON HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S OCOTILLO AVE
BENSON AZ
85602
US

IV. Provider business mailing address

450 S OCOTILLO AVE
BENSON AZ
85602-6403
US

V. Phone/Fax

Practice location:
  • Phone: 520-586-2261
  • Fax: 520-586-2265
Mailing address:
  • Phone: 520-586-2261
  • Fax: 520-586-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH-096
License Number StateAZ

VIII. Authorized Official

Name: MR. KENNETH GORANSON
Title or Position: CFO
Credential:
Phone: 520-720-6508