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General NPI Number Information
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NPI Number | 1225438104
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Entity Type | Organization
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Legal Business Name | BISBEE HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 10524 E HIGHWAY 92
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City | HEREFORD
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State | AZ
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Zip | 85615-8371
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Country | US
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Telephone | 520-366-0300
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Fax | 520-432-8018
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Provider Business Mailing Address
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Address Line | 10524 E HIGHWAY 92
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City | HEREFORD
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State | AZ
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Zip | 85615-8371
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Country | US
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Telephone | 520-366-0300
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Fax | 520-432-8018
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES DICKSON
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Credential |
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Telephone | 520-432-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | H0098
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License Number State | AZ
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