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General NPI Number Information
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NPI Number | 1699103713
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Entity Type | Organization
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Legal Business Name | COCHISE HEALTH AND WELLNESS PLC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 4669 N COMMERCE DR SUITE 4
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2497
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Country | US
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Telephone | 520-226-8316
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Fax | 877-303-6952
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Provider Business Mailing Address
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Address Line | 4669 N COMMERCE DR SUITE 4
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2497
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Country | US
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Telephone | 520-226-8316
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Fax | 877-303-6952
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Authorized Official
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Title or Position | OWNER
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Name | SARAH LOUISE BIVENS
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Credential | FNP
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Telephone | 520-226-8316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | AZ
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