Healthcare Provider Details

I. General information

NPI: 1861749111
Provider Name (Legal Business Name): FLORENCE ADAMSVILLE HOSPITAL, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W ADAMSVILLE RD
FLORENCE AZ
85132-8582
US

IV. Provider business mailing address

PO BOX 2289
FLORENCE AZ
85132-3043
US

V. Phone/Fax

Practice location:
  • Phone: 520-429-4043
  • Fax: 240-252-5668
Mailing address:
  • Phone: 520-429-4043
  • Fax: 240-252-5668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GARY L FAULKNER
Title or Position: CEO
Credential:
Phone: 520-429-4043