HAVASU REGIONAL MEDICAL CENTER LLC (NPI# 1467673293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467673293 |
| Entity Type | Organization |
| Organization Name | HAVASU REGIONAL MEDICAL CENTER LLC |
| Other Organization Name | HAVASU SURGERY CENTER |
| Practice Address |
1775 Mcculloch Blvd N Lake Havasu City AZ 86403-6549 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 9288558185 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | KATHY J. TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | Y |
| Parent Organization Name | HAVASU REGIONAL MEDICAL CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 231644 | 05 |
| Other Name | Type Code |
|---|---|
| Havasu Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093154130 | Havasu Regional Medical Center LLC | Skilled Nursing Facility | 1811 Mesquite Ave, Lake Havasu City, AZ 86403-5668 | 2013-06-21 |
| 1972825644 | Havasu Regional Medical Center LLC | Radiology | 1799 Kiowa Ave, # 104, Lake Havasu City, AZ 86403-2881 | 2010-02-23 |
| 1780761866 | Havasu Regional Medical Center LLC | General Acute Care Hospital | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2006-11-01 |
| 1063511962 | Havasu Regional Medical Center LLC | Anesthesiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2006-09-21 |
| Street Address |
1775 MCCULLOCH BLVD N |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-6549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386646081 | Mandeep Powar | Specialist | 1775 Mcculloch Blvd N, Lake Havasu City, AZ 86403-6549 | 2005-08-11 |
| 1447573621 | Jaidyn Med Care Ltd | Clinic/Center | 1775 Mcculloch Blvd N, Lake Havasu City, AZ 86403-6549 | 2010-03-02 |
| 1235327917 | Powar Pain Clinic | Clinic/Center | 1775 Mcculloch Blvd N, Lake Havasu City, AZ 86403-6549 | 2007-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386619484 | Havasu Surgery Center | Clinic/Center | 1775 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2006-02-22 |
| 1174582829 | Havasu Foot & Ankle Center | Clinic/Center | 90 Riviera Dr, Lake Havasu City, AZ 86403-5716 | 2006-03-21 |
| 1497727093 | Barnet Dulaney Perkins Eye Center II Pllc | Clinic/Center | 40 Capri Blvd, Suite 102, Lake Havasu City, AZ 86403-5661 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940274 | Arizona Centers for Orthobiologics, LLC | Clinic/Center | 610 E Baseline Rd Ste 103, Tempe, AZ 85283-1204 | 2020-10-21 |
| 1336756592 | Pinnacle Asc LLC | Clinic/Center | 3329 E Bell Rd # A2-a5, Phoenix, AZ 85032-2756 | 2020-09-30 |
| 1053927210 | Gila River Surgical Center LLC | Clinic/Center | 2340 W Parkside Ln Ste H107, Phoenix, AZ 85027-1274 | 2020-09-22 |
| 1134735384 | Rembrandt Treatment Center LLC | Clinic/Center | 6859 E Rembrandt Ave Ste 101, Mesa, AZ 85212-3629 | 2020-09-22 |
| 1952917445 | Aurora Surgical Center LLC | Clinic/Center | 1254 W University Ave Ste 130, Flagstaff, AZ 86001-7217 | 2020-09-20 |
| 1225641046 | Ambulatory Surgery Centers, LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 110, Avondale, AZ 85392 | 2020-08-31 |
| 1780292110 | Buckeye South LLC | Clinic/Center | 23390 W Yuma Rd Ste 101, Buckeye, AZ 85326-3106 | 2020-07-22 |
| 1457976383 | Vhc-1 | Clinic/Center | 8900 E Raintree Dr Ste 100, Scottsdale, AZ 85260-7307 | 2020-06-16 |
| 1003439712 | Comprehensive Surgical Care of Sun City | Clinic/Center | 14642 N Del Webb Blvd Ste 100, Sun City, AZ 85351-2101 | 2020-05-28 |
| 1013539709 | Bsc Biltmore LLC | Clinic/Center | 2222 E Highland Ave Ste 100, Phoenix, AZ 85016-4874 | 2020-05-15 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on HAVASU REGIONAL MEDICAL CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.