NORTH COUNTRY HEALTHCARE, INC. (NPI# 1033359468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033359468 |
Entity Type | Organization |
Organization Name | NORTH COUNTRY HEALTHCARE, INC. |
Practice Address |
2090 N. Smoketree Ave Lake Havasu City AZ 86403 |
Mailing Address |
Po Box 3630 Flagstaff AZ 86003-3630 |
Practice Telephone | 9288541800 |
Practice Fax Number | 9288541818 |
Mailing Telephone | 9285229879 |
Mailing Fax Number | 9285229880 |
Enumeration Date | 2009-02-25 |
Last Update Date | 2016-07-26 |
Authorized Official Name | ANNE NEWLAND (CEO/CMO) |
Authorized Official Telephone | 9285229576 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | NORTH COUNTRY HEALTHCARE, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
AZ | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 433079 | 05 |
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 |
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 |
1649334442 | North Country Healthcare, Inc. | Pharmacy | 2920 North 4th Street, Flagstaff, AZ 86004 | 2006-12-19 |
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 |
2090 N. SMOKETREE AVE |
City | LAKE HAVASU CITY |
State | AZ |
Zip Code | 86403 |
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 | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
Find all providers with the same taxonomy |
City | LAKE HAVASU CITY |
Zip Code | 86403 |
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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.