NORTH COUNTRY HEALTHCARE, INC.


Address: 2090 N. Smoketree Ave, Lake Havasu City, AZ 86403
Phone: 9288541800

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).

Provider Overview

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.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
AZ Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ 433079 05

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities NORTH COUNTRY HEALTHCARE, INC. 2920 N 4th St, Flagstaff, AZ 86004-1816

Office Location

Street Address 2090 N. SMOKETREE AVE
City LAKE HAVASU CITY
State AZ
Zip Code 86403

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

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
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Competitor

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City LAKE HAVASU CITY
Zip Code 86403

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Dataset Information

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.

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