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NPI Code Detail

MEDICARE: PAYSON HOSPITAL CORPORATION

MEDICARE: PAYSON 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
1282N00000XGeneral Acute Care HospitalH0089AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1IZ0088OTHERHEALTHNET
20912454OTHERINTERGROUP
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4PHH070030001OTHERAHCCCS
51894383OTHERDEPT OF LABOR
6AZ0205320OTHERBCBS

General Provider Information

NPI Number : 1881665545
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAYSON HOSPITAL CORPORATION
Provider Business Mailing Address
First Line : 807 S PONDEROSA ST
Second Line :
City : PAYSON
State : AZ
Zip : 85541-5542
Country : US
Telephone Number : 928-474-3222
Fax Number :
Provider Business Practice Location Address
First Line : 807 S PONDEROSA ST
Second Line :
City : PAYSON
State : AZ
Zip : 85541-5542
Country : US
Telephone Number : 928-474-3222
Fax Number :
Authorized Official
Title or Position : DIR BUSINESS OFFICE SUP/AUTH OFFICI
Name : LAURIE HOLTSFORD
Credential :
Telephone Number : 615-465-7488
Provider Enumeration Date : 01/31/2006
Last Update Date : 11/02/2011

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Directions to “PAYSON HOSPITAL CORPORATION ” Practice Location

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