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General NPI Number Information
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NPI Number | 1912437211
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Entity Type | Organization
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Legal Business Name | BLUE HILLS QUICK CARE LLC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 151 N WHITE MOUNTAIN RD STE E
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City | SHOW LOW
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State | AZ
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Zip | 85901
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Country | US
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Telephone | 480-886-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 W IRVINE RD
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City | PHOENIX
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State | AZ
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Zip | 85086-9110
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Country | US
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Telephone | 480-886-4466
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Fax |
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Authorized Official
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Title or Position | OWNER/FNP
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Name | HOLLY ENGELMAN
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Credential | FNP
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Telephone | 480-886-4466
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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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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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