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General NPI Number Information
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NPI Number | 1275588345
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Entity Type | Organization
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Legal Business Name | MT GRAHAM REGIONAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 1600 S 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546
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Country | US
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Telephone | 928-348-4000
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Fax | 928-348-4018
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Provider Business Mailing Address
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Address Line | 1600 20TH AVE
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City | SAFFORD
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State | AZ
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Zip | 85546
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Country | US
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Telephone | 928-348-4000
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Fax | 928-348-4018
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ROLAND KNOX
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Credential | CEO
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Telephone | 928-348-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | H0140
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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