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General NPI Number Information
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NPI Number | 1235732702
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Entity Type | Organization
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Legal Business Name | NORTHERN ARIZONA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 5130 N US HIGHWAY 89
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-2837
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Country | US
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Telephone | 928-773-2054
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Fax | 928-773-2286
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Provider Business Mailing Address
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Address Line | 1200 N. BEAVER STREET ATTN: MANGED CARE CONTRACTING
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 928-213-6543
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Fax | 928-214-3613
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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