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General NPI Number Information
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NPI Number | 1457924920
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Entity Type | Organization
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Legal Business Name | BENSON HOSPITAL CORPORATION
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 13370 E MARY ANN CLEVELAND WAY
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City | VAIL
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State | AZ
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Zip | 85641-8610
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Country | US
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Telephone | 520-720-6512
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Fax |
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Provider Business Mailing Address
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Address Line | 450 S OCOTILLO AVE
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City | BENSON
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State | AZ
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Zip | 85602-6403
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Country | US
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Telephone | 520-720-6512
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Fax | 520-586-7283
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Authorized Official
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Title or Position | CFO
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Name | BRET HICKS
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Credential |
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Telephone | 520-324-1614
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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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