HAVASU REGIONAL MEDICAL CENTER LLC (NPI# 1780761866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780761866 |
| Entity Type | Organization |
| Organization Name | HAVASU REGIONAL MEDICAL CENTER LLC |
| Other Organization Name | HAVASU REGIONAL MEDICAL CENTER |
| Practice Address |
101 Civic Center Ln Lake Havasu City AZ 86403-5607 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 9288558185 |
| Practice Fax Number | 9285055778 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | KATHY J TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
H4027 | AZ | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | FECA | 16620040 | 01 |
| AZ | 445131 | 05 | |
| CA | XHSP43227 | 05 | |
| CA | XHSP33227 | 05 |
| Other Name | Type Code |
|---|---|
| Havasu Regional Medical 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 |
| 1467673293 | Havasu Regional Medical Center LLC | Clinic/Center | 1775 Mcculloch Blvd N, Lake Havasu City, AZ 86403-6549 | 2007-05-01 |
| 1063511962 | Havasu Regional Medical Center LLC | Anesthesiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2006-09-21 |
| Street Address |
101 CIVIC CENTER LN |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176233 | Pamela B. Reband | Anesthesiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2005-06-28 |
| 1659995652 | Alana Stern | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2020-06-04 |
| 1245702927 | Michael Barber | Registered Nurse | 101 Civic Center Ln, Lake Havasu City, AZ 86403 | 2018-12-19 |
| 1891276630 | Brian Andrew | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2018-08-28 |
| 1497264873 | Pinnacle Radiology Services | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2017-09-28 |
| 1821516287 | Jaime Wasik | Nurse Practitioner | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2017-09-06 |
| 1144776055 | Paul Queior | Physician Assistant | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2016-08-30 |
| 1891146957 | Misty Maple | Nurse Practitioner | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2016-06-29 |
| 1316319460 | Sarah Fraser | Specialist/Technologist, Other | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2015-10-28 |
| 1780067280 | Samer Asem Haddad | Internal Medicine | 101 Civic Center Ln, Lake Havasu City, AZ 86403 | 2015-07-01 |
| Find all providers in the same location | ||||
| 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 | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659519700 | Elizabeth A Briere | General Acute Care Hospital | 1977 Acoma Blvd W, Lake Havasu City, AZ 86403-2958 | 2009-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831637743 | Randi Riley | General Acute Care Hospital | 7520 S Malcolm Ave, Tucson, AZ 85746-2529 | 2017-02-11 |
| 1760920029 | Wendy Patton | General Acute Care Hospital | 10180 E King Manor Dr, Tucson, AZ 85730-4482 | 2017-02-07 |
| 1750749214 | Summit Healthcare | General Acute Care Hospital | 181 East Sylvester, Show Low, AZ 85901 | 2016-01-29 |
| 1528445269 | Tania Thorne | General Acute Care Hospital | Hwy 86 Topowa Road, Sells, AZ 85642 | 2015-05-01 |
| 1952704173 | Wickenburg Community Hospital | General Acute Care Hospital | 12023 W Windrose Dr, El Mirage, AZ 85335-4323 | 2014-10-01 |
| 1285938456 | Gila River Health Care | General Acute Care Hospital | 483 W. Seed Farm, Sacaton, AZ 85147-0000 | 2011-01-03 |
| 1710204433 | Florence Hospital, LLC | General Acute Care Hospital | 450 W Adamsville Rd, Florence, AZ 85132 | 2010-04-21 |
| 1386633915 | Gila River Health Care Corporation | General Acute Care Hospital | 48203 W. Farrell Rd., Maricopa, AZ 85139-0038 | 2005-10-17 |
| 1366993636 | Fort Defiance Indian Hospital Board, Inc | General Acute Care Hospital | Corner of Route N12 and N7, Fort Defiance Indian Hospital Board, Inc, Fort Defiance, AZ 86504-0589 | 2016-10-20 |
| 1184171894 | Chinle Comprehensive Health Care Facility | General Acute Care Hospital | Highway 191, Hospital Turnoff, Chinle, AZ 86503 | 2016-09-10 |
| 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.