DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BLACK CANYON COMMUNITY HEALTH CENTER

MEDICARE: BLACK CANYON COMMUNITY HEALTH CENTER
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
1101Y00000XCounselor
2207QA0000XAdolescent Medicine (Family Medicine) Physician
3261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1992438642
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLACK CANYON COMMUNITY HEALTH CENTER
Provider Business Mailing Address
First Line : PO BOX 1958
Second Line :
City : BLACK CANYON CITY
State : AZ
Zip : 85324-1958
Country : US
Telephone Number : 623-374-0200
Fax Number : 623-374-5576
Provider Business Practice Location Address
First Line : 19251 E OASIS DR
Second Line :
City : BLACK CANYON CITY
State : AZ
Zip : 85324-8878
Country : US
Telephone Number : 623-374-0200
Fax Number : 623-374-5576
Authorized Official
Title or Position : CEO
Name : RANDY CHARLES HANCOCK
Credential : DO
Telephone Number : 623-374-0200
Provider Enumeration Date : 07/08/2022
Last Update Date : 12/16/2022

Similar Medicare Providers

1467432971 — DR. RANDY CHARLES HANCOCK DO
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 623-374-0200
Practice Fax: 623-374-5576
1780858878 — DR. ANDREA KAY IRVING D.O.
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 623-374-0200
Practice Fax:
1679723217 — BLACK CANYON COMMUNITY HEALTH CENTER
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 623-374-0200
Practice Fax: 623-374-5576
1033690169 — PREVENTATIVE DENTAL CARE PLLC
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 162-344-4232
Practice Fax:
1225685118 — MATTHEW LYNN MCELROY PA-C
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 623-374-0200
Practice Fax:
1720748049 — RADIANT DENTAL LLC
Practice Location Address:
19251 E OASIS DR
BLACK CANYON CITY, AZ
85324-8878
Practice Phone: 623-526-2607
Practice Fax:

Directions to “BLACK CANYON COMMUNITY HEALTH CENTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.