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General NPI Number Information
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NPI Number | 1629093539
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Entity Type | Organization
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Legal Business Name | LA PAZ REGIONAL HOSPITAL, INC.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 39726 HARQUAHALA ROAD
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City | SALOME
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State | AZ
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Zip | 85348
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Country | US
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Telephone | 928-859-3460
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Fax | 928-859-3475
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Provider Business Mailing Address
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Address Line | 1200 W MOHAVE RD
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City | PARKER
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State | AZ
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Zip | 85344-6349
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Country | US
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Telephone | 928-669-9201
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Fax | 928-669-7417
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Authorized Official
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Title or Position | CEO
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Name | MRS. KEVIN BROWN
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Credential |
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Telephone | 928-669-7300
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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 | H0138
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License Number State | AZ
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