Healthcare Provider Details

I. General information

NPI: 1265695415
Provider Name (Legal Business Name): BISBEE HOSPITAL ASSOCIATION DBA CQCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COLE AVE
BISBEE AZ
85603-1327
US

IV. Provider business mailing address

101 COLE AVE
BISBEE AZ
85603-1327
US

V. Phone/Fax

Practice location:
  • Phone: 520-432-6481
  • Fax: 520-432-5082
Mailing address:
  • Phone: 520-432-6481
  • Fax: 520-432-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberRN083567
License Number StateAZ

VIII. Authorized Official

Name: PEGGY FRANCOIS
Title or Position: ANESTHETIST
Credential: CRNA
Phone: 520-432-6481