YAVAPAI REGIONAL MEDICAL CENTER (NPI# 1639282999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639282999 |
| Entity Type | Organization |
| Organization Name | YAVAPAI REGIONAL MEDICAL CENTER |
| Practice Address |
1003 Willow Creek Rd Outpatient Pharmacy Prescott AZ 86301-1641 |
| Practice Telephone | 9287715520 |
| Practice Fax Number | 9287715521 |
| Mailing Telephone | 9287715520 |
| Mailing Fax Number | 9287715521 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GREGORY JOHN HUFFAKER (OUTPATIENT PHARMACY MANAGER) |
| Authorized Official Telephone | 9287715520 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 101741 | AZ | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | YAVAPAI REGIONAL MEDICAL CENTER | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 |
| Street Address |
1003 WILLOW CREEK RD OUTPATIENT PHARMACY |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528343 | Robert William Halterman | Family Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2005-06-15 |
| 1083211320 | Wendy E Nelson | Dietitian, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1668 | 2020-10-08 |
| 1750909008 | Shawn Jeffery Mitchell | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2020-07-13 |
| 1669019683 | Justin Earl Rogers | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-12-09 |
| 1477116911 | Anna Mattson | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-04-19 |
| 1790276608 | Phillip Allen Schafer | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301 | 2018-05-25 |
| 1144724618 | Richard Barclay Thompson | Respiratory Therapist, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2018-03-20 |
| 1245774397 | Stephen Green | Physician Assistant | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-12-08 |
| 1427500107 | Zachary Archer | Perfusionist | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-10-28 |
| 1952753675 | Candice Panton | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538680269 | Thumb Butte Pharmacy LLC | Pharmacy | 3120 Willow Creek Rd # 150, Prescott, AZ 86301-6610 | 2017-07-03 |
| 1194813873 | Bashas' Inc. | Pharmacy | 1761 E State Route 69, Prescott, AZ 86301-5663 | 2006-10-10 |
| 1023128626 | Costco Wholesale Corporation | Pharmacy | 3911 Highway 69, Prescott, AZ 86301 | 2006-08-30 |
| 1972534089 | K Mart Corp | Pharmacy | 1048 Willow Creek Rd, Prescott, AZ 86301-1642 | 2006-07-06 |
| 1528064367 | Super D Drug Acquisition Co. | Pharmacy | 1430 W 1st St N, Prescott, AR 71857-3339 | 2005-06-27 |
| 1992875074 | Wpm Community Pharmacies LLC | Pharmacy | 1430 W 1st St N, Prescott, AR 71857-3339 | 2006-11-08 |
| 1053337444 | J L & C Enterprises Inc | Pharmacy | 406 W Goodwin St, Prescott, AZ 86303-3737 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244861 | Canyonlands Community Healthcare | Pharmacy | 103 Fairgrounds Rd, Duncan, AZ 85534-8234 | 2020-10-26 |
| 1790384212 | Copilot Provider Support Services | Pharmacy | 8700 East Pinnacle Peak Road Ste 111, Johnson Bank Building, Scottsdale, AZ 85255-8525 | 2020-10-26 |
| 1366041501 | White Nile | Pharmacy | 4338 W Thomas Rd Unit E5, Phoenix, AZ 85031-3878 | 2020-10-20 |
| 1366050536 | Mariposa Community Health Center | Pharmacy | 1103 Circulo Mercado, Rio Rico, AZ 85648-6248 | 2020-07-14 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1952924847 | Cheryl Mackie | Pharmacy | 8010 E Mcdowell Rd Ste 201-206, Scottsdale, AZ 85257-3867 | 2020-05-26 |
| 1306472865 | Cordant Pharmacy Arizona, LLC | Pharmacy | 6641 E Baywood Ave Ste 101, Mesa, AZ 85206-1723 | 2020-03-17 |
| 1215575824 | Maricopa County Special Health Care District | Pharmacy | 8088 W Whitney Dr, Peoria, AZ 85345 | 2019-12-13 |
| 1811532609 | Nexus Patient Services | Pharmacy | 5080 N 40th St Ste 300, Phoenix, AZ 85018-2164 | 2019-11-15 |
| 1649813320 | Hi-health-rx LLC | Pharmacy | 15207 N 75th St Ste 105, Scottsdale, AZ 85260-2445 | 2019-10-24 |
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| 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.