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General NPI Number Information
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NPI Number | 1235654336
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Entity Type | Organization
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Legal Business Name | VERDE VALLEY MEDICAL CENTER
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 269 S CANDY LN
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4158
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Country | US
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Telephone | 928-639-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 269 S CANDY LN
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. ROBERT COFIELD
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Credential |
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Telephone | 928-773-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y007202
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License Number State | AZ
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