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General NPI Number Information
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NPI Number | 1205327582
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Entity Type | Organization
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Legal Business Name | BENSON HOSPITAL CORPORATION
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 688 W 4TH ST STE B
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City | BENSON
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State | AZ
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Zip | 85602
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Country | US
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Telephone | 520-720-6512
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Fax | 520-720-6522
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Provider Business Mailing Address
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Address Line | 450 S OCOTILLO AVE
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City | BENSON
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State | AZ
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Zip | 85602-6403
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Country | US
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Telephone | 520-586-2261
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Fax | 520-586-2265
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Authorized Official
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Title or Position | CFO
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Name | KENNETH GORANSON
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Credential |
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Telephone | 520-586-2261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | H096
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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