Healthcare Provider Details

I. General information

NPI: 1013160290
Provider Name (Legal Business Name): RCHP-SIERRA VISTA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 HIGHWAY 82
SONOITA AZ
85637
US

IV. Provider business mailing address

300 EL CAMINO REAL
SIERRA VISTA AZ
85635-2812
US

V. Phone/Fax

Practice location:
  • Phone: 520-417-3001
  • Fax:
Mailing address:
  • Phone: 520-417-3001
  • Fax: 520-417-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN L PAGE
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-844-9849