MT GRAHAM REGIONAL MEDICAL CENTER INC (NPI# 1770549974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770549974 |
| Entity Type | Organization |
| Organization Name | MT GRAHAM REGIONAL MEDICAL CENTER INC |
| Other Organization Name | MT. GRAHAM REGIONAL MEDICAL CENTER HOSPICE SERVICES |
| Practice Address |
1600 S. 20th Ave Bldg. E Safford AZ 85546 |
| Practice Telephone | 9283484063 |
| Practice Fax Number | 9283483868 |
| Mailing Telephone | 9283484063 |
| Mailing Fax Number | 9283483868 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-09-27 |
| Authorized Official Name | MR. KEITH BRYCE (CFO) |
| Authorized Official Telephone | 9283484099 |
| Is Organization Subpart | Y |
| Parent Organization Name | MT GRAHAM REGIONAL MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | HSPC-43 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 317786 | 05 | |
| AZ | CLIA NUMBER | 03D0886073 | 01 |
| AZ | ADHS NUMBER | HSPC-43 | 01 |
| Other Name | Type Code |
|---|---|
| Mt. Graham Regional Medical Center Hospice Services | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659337848 | Mt Graham Regional Medical Center Inc | Home Health | 1600 S. 20th Ave., Bldg. E, Safford, AZ 85546 | 2006-04-25 |
| 1003174715 | Mt Graham Regional Medical Center Inc | Home Health | 1600 S 20th Ave Bldg E, Safford, AZ 85546-4011 | 2012-05-01 |
| 1346528759 | Mt Graham Regional Medical Center Inc | Clinic/Center | 2250 W 16th St, Safford, AZ 85546-4081 | 2011-08-02 |
| 1285845800 | Mt Graham Regional Medical Center Inc | Medicare Defined Swing Bed Unit | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2007-05-25 |
| 1275588345 | Mt Graham Regional Medical Center Inc | General Acute Care Hospital | 1600 S 20th Ave, Safford, AZ 85546 | 2006-05-24 |
| Street Address |
1600 S. 20TH AVE BLDG. E |
| City | SAFFORD |
| State | AZ |
| Zip Code | 85546 |
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| 1508238700 | Southeastern Arizona Consumer-run Services | Clinic/Center | 628 Main St., Safford, AZ 85546 | 2015-10-27 |
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| 1841634060 | Rs5 Investments LLC | Family Medicine | 1515 S. 20th Ave, Safford, AZ 85546 | 2013-04-18 |
| 1689946162 | South Eastern Arizona Behavioral Health Services, Inc. | Clinic/Center | 1609 S. 1st Ave, Safford, AZ 85546 | 2012-01-31 |
| 1669741435 | Southeastern Arizona Behavioral Health Services, Inc | Clinic/Center | 1609 S 1st Ave, Safford, AZ 85546 | 2011-12-22 |
| 1912295106 | Canyonlands | Clinic/Center | 618 S. Central Avenue, Safford, AZ 85546 | 2011-07-21 |
| 1255669354 | Dovetree Counseling Associates, Inc. | Community/Behavioral Health | 1906 Thatcher Blvd, Safford, AZ 85546 | 2009-12-01 |
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| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
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|---|---|---|---|---|
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| 1104434141 | First Choice Hospice LLC | Hospice Care, Community Based | 1738 E Thomas Rd, Phoenix, AZ 85016-7604 | 2020-07-15 |
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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.