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General NPI Number Information
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NPI Number | 1346528759
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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 | 08/02/2011
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 2175 W 16TH ST
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City | SAFFORD
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State | AZ
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Zip | 85546-0011
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Country | US
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Telephone | 928-348-4037
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Fax | 844-271-2379
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Provider Business Mailing Address
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Address Line | 2175 W 16TH ST
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City | SAFFORD
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State | AZ
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Zip | 85546-0011
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Country | US
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Telephone | 928-348-4037
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Fax | 844-271-2379
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Authorized Official
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Title or Position | DIRECTOR OUTPATIENT CLINICS
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Name | DIANE HANSEN
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Credential |
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Telephone | 928-348-4037
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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 |
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License Number State |
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