Healthcare Provider Details

I. General information

NPI: 1326256884
Provider Name (Legal Business Name): COUNTY OF APACHE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S MOUNTAIN AVE SUITE 102
SPRINGERVILLE AZ
85938-5102
US

IV. Provider business mailing address

323 S MOUNTAIN AVE 102
SPRINGERVILLE AZ
85938-5102
US

V. Phone/Fax

Practice location:
  • Phone: 928-333-2415
  • Fax: 928-333-5876
Mailing address:
  • Phone: 928-333-2415
  • Fax: 928-333-5876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberOTC3206
License Number StateAZ

VIII. Authorized Official

Name: CHRIS G. SEXTON
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 928-337-7532