Healthcare Provider Details

I. General information

NPI: 1629028295
Provider Name (Legal Business Name): LA PAZ REGIONAL HOSPITAL,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W MOHAVE RD
PARKER AZ
85344-6349
US

IV. Provider business mailing address

1200 W MOHAVE RD
PARKER AZ
85344-6349
US

V. Phone/Fax

Practice location:
  • Phone: 928-669-9201
  • Fax: 928-669-7422
Mailing address:
  • Phone: 928-669-9201
  • Fax: 928-669-7422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0138
License Number StateAZ

VIII. Authorized Official

Name: MR. KEVIN BROWN
Title or Position: CEO
Credential:
Phone: 928-669-7300