NORTH COUNTRY HEALTHCARE, INC. (NPI# 1649334442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649334442 |
| Entity Type | Organization |
| Organization Name | NORTH COUNTRY HEALTHCARE, INC. |
| Practice Address |
2920 North 4th Street Flagstaff AZ 86004 |
| Practice Telephone | 9282130589 |
| Practice Fax Number | 9282130597 |
| Mailing Telephone | 9282130589 |
| Mailing Fax Number | 9282130597 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-12-06 |
| Authorized Official Name | ANN M ROGGENBUCK (CEO) |
| Authorized Official Telephone | 9287748325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
3287 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | DEA | BN6978021 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619345675 | North Country Healthcare, Inc. | Family Medicine | 1120 West University Avenue, Suite 101, Flagstaff, AZ 86001-3630 | 2015-09-08 |
| 1033454707 | North Country Healthcare, Inc. | Family Medicine | 2600 E. Show Low Lake Rd., Show Low, AZ 85901 | 2012-12-06 |
| 1750691788 | North Country Healthcare, Inc. | Clinic/Center | 301 S 7th Street, Williams, AZ 86045 | 2010-10-08 |
| 1760798680 | North Country Healthcare, Inc. | Clinic/Center | 2585 S. Miracle Mile, Ste 116, Bullhead, AZ 86442 | 2010-08-30 |
| 1073740098 | North Country Healthcare, Inc. | Clinic/Center | 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 | 2009-06-17 |
| 1033359468 | North Country Healthcare, Inc. | Clinic/Center | 2090 N. Smoketree Ave, Lake Havasu City, AZ 86403 | 2009-02-25 |
| 1336329788 | North Country Healthcare, Inc. | Clinic/Center | 1510 N Stockton Hill Rd, Kingman, AZ 86401 | 2007-11-13 |
| 1235254475 | North Country Healthcare, Inc. | Clinic/Center | 22585 West Oak Street, Seligman, AZ 86337 | 2007-03-20 |
| 1275657363 | North Country Healthcare, Inc. | Clinic/Center | 620 W. Lee Street, Winslow, AZ 86047 | 2007-03-16 |
| 1790809879 | North Country Healthcare, Inc. | Clinic/Center | 488 S. Mountain Ave., Springerville, AZ 85938 | 2007-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH COUNTRY HEALTHCARE, INC. | 2920 N 4th St, Flagstaff, AZ 86004-1816 |
| Street Address |
2920 NORTH 4TH STREET |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387805 | Michael Joseph Oxtoby | Counselor | 2625 N. King St., Flagstaff, AZ 86004 | 2020-05-08 |
| 1083264501 | Dazhoni Elizabeth Scott | Counselor | 1500 E. Cedar Avenue #26, 2110 N. East St Apt C, Flagstaff, AZ 86004 | 2019-09-17 |
| 1760948046 | Emily Bauerle | Social Worker | 3009 N West St, Flagstaff, AZ 86004 | 2019-02-12 |
| 1992295745 | Kaibab Behavioral Services, Pllc | Behavioral Analyst | 2323 E Greenlaw Lane, Suite 12a, Flagstaff, AZ 86004 | 2018-05-17 |
| 1083115364 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 8800 Marys Drive, Flagstaff, AZ 86004 | 2018-02-22 |
| 1710391081 | Janet Coleman | Hearing Instrument Specialist | 1851 E Butler Avenue, Flagstaff, AZ 86004 | 2014-06-16 |
| 1568703163 | Mercy Timoh | Pharmacist | 4255 E. Soliere Ave., Flagstaff, AZ 86004 | 2013-03-06 |
| 1053617217 | Scott Nichols | Veterinarian | 6122 Abineau Canyon Drive, Flagstaff, AZ 86004 | 2011-02-07 |
| 1366745218 | Karoline S. Mariano | Registered Nurse | 3480 East Route 66, Flagstaff, AZ 86004 | 2010-12-15 |
| 1912209719 | Payal Parekh | Pharmacist | 1500 E Cedar, Flagstaff, AZ 86004 | 2010-11-30 |
| Find all providers in zip 86004 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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: new] |
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| 1245357706 | West Kingman Pharmacy, LLC | Pharmacy | 3135 N Stockton Hill Rd, Kingman, AZ 86401 | 2007-03-22 |
| 1730295684 | State of Arizona | Pharmacy | 1295 N Martin, Tucson, AZ 85721-0001 | 2006-08-22 |
| 1023122843 | Cardiojost, Inc | Pharmacy | 140 S Power Rd Ste 102, Mesa, AZ 85206-5297 | 2006-08-18 |
| 1376502054 | Sunset Community Health Center Inc | Pharmacy | 815 E Cesar Chavez Blvd, San Luis, AZ 85349 | 2006-03-21 |
| 1275519241 | El Rio Health Center (southwest) | Pharmacy | 1510 W Commerce Court, Tucson, AZ 85746-6015 | 2005-12-21 |
| 1447242417 | Cigna Health Care of Arizona Inc | Pharmacy | 1920 E Baseline Rd, Tempe, AZ 85283-1511 | 2005-08-16 |
| 1992797930 | Cigna Health Care of Arizona Inc | Pharmacy | 9069 W Thunderbird, Peoria, AZ 85381 | 2005-08-16 |
| 1528678000 | Sun Life Family Health Center Inc | Pharmacy | 1040 W American Ave, Oracle, AZ 85623-6089 | 2020-08-09 |
| Find all providers with the same taxonomy | ||||
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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.