Healthcare Provider Details

I. General information

NPI: 1871534487
Provider Name (Legal Business Name): YAVAPAI COMMUNITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 E FLORENTINE RD
PRESCOTT VALLEY AZ
86314-2245
US

IV. Provider business mailing address

7700 E FLORENTINE RD
PRESCOTT VALLEY AZ
86314-2245
US

V. Phone/Fax

Practice location:
  • Phone: 928-445-2700
  • Fax: 928-458-2015
Mailing address:
  • Phone: 928-759-5997
  • Fax: 928-771-5722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH3964
License Number StateAZ

VIII. Authorized Official

Name: MR. JASON METCALF
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 928-771-5564