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General NPI Number Information
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NPI Number | 1518968767
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Entity Type | Organization
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Legal Business Name | BISBEE HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 101 COLE AVE
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City | BISBEE
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State | AZ
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Zip | 85603-1327
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Country | US
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Telephone | 520-432-6481
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Fax | 520-432-5082
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Provider Business Mailing Address
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Address Line | 101 COLE AVE
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City | BISBEE
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State | AZ
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Zip | 85603-1327
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Country | US
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Telephone | 520-432-5383
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Fax | 520-432-5082
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES J DICKSON
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Credential |
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Telephone | 520-432-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | H-0098
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License Number State | AZ
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