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1255302766

NPI Code Detail

MEDICARE: BULLHEAD CITY HOSPITAL CORPORATION

MEDICARE: BULLHEAD CITY HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	H0156	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	531237	OTHER		AHCCCS
4	0206770	OTHER		BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	A6155	OTHER		BC MI
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255302766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULLHEAD CITY HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 847173
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2735 SILVER CREEK RD
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7924
Country	:	US
Telephone Number	:	928-763-2273
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/DELEGATED OFFICIAL
Name	:	PAULA M LALOR
Credential	:
Telephone Number	:	629-215-3953

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/29/2021

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Directions to “BULLHEAD CITY HOSPITAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

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