GOODWILL OF NORTHERN ARIZONA


Address: 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403
Phone: 9285269188

GOODWILL OF NORTHERN ARIZONA (NPI# 1053694448) 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) 1053694448
Entity Type Organization
Organization Name GOODWILL OF NORTHERN ARIZONA
Practice Address 1990 Mcculloch Blvd North
Lake Havasu City
AZ 86403
Mailing Address 4308 E. Route 66
Flagstaff
AZ 86004
Practice Telephone 9285269188
Practice Fax Number 9285269240
Mailing Telephone 9285269188
Mailing Fax Number 9285269274
Enumeration Date 2011-09-22
Last Update Date 2016-05-25
Authorized Official Name LIZ MCGINLAY (VP MISSION SERVICES)
Authorized Official Telephone 9285269188
Authorized Official Credential B.S. ED. GCDF
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 302F00000X Exclusive Provider Organization Managed Care Organizations

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1477836880 Goodwill of Northern Arizona Exclusive Provider Organization 2369 Airway Avenue, Kingman, AZ 86401 2011-09-21
1104067008 Goodwill of Northern Arizona Voluntary or Charitable 2225 N Steves Blvd, Flagstaff, AZ 86004-6115 2009-03-23

Office Location

Street Address 1990 MCCULLOCH BLVD NORTH
City LAKE HAVASU CITY
State AZ
Zip Code 86403

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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
1114200664 House On The Riviera Assisted Living Assisted Living Facility 190 Riviera Dr., Lake Havasu City, AZ 86403 2011-09-21
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Taxonomy Information

Taxonomy Code 302F00000X
Grouping Managed Care Organizations
Classification Exclusive Provider Organization

Taxonomy Definition

(1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

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NPI Name Taxonomy Address Enumeration
1336594951 Milemarkers Therapy Exclusive Provider Organization 1515 Lake Havasu Ave N, Lake Havasu City, AZ 86404-1177 2016-05-02

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1497299101 Lifestyles Exclusive Provider Organization 4385 E Wild Elk Trl, Flagstaff, AZ 86004-7921 2016-12-14
1356794150 David Ryan Schaner Exclusive Provider Organization 12533 W Coldwater Springs Blvd, Avondale, AZ 85323-8320 2016-07-15
1528415650 Nazcare, Inc. Exclusive Provider Organization 8200 E. Jacque Dr., Prescott Valley, AZ 86314 2016-05-18
1508228701 Sfc Shane Exclusive Provider Organization 460 E Osage Ave, 1, Apache Junction, AZ 85119-3748 2016-03-25
1568845592 Desert Journey, LLC Exclusive Provider Organization 904 E Prescott Pl, Chandler, AZ 85249-5131 2015-07-08
1386049419 Linda L Austin, Md PC Exclusive Provider Organization 1301 E Mcdowell Rd Ste 103, Phoenix, AZ 85006-2605 2014-10-31
1720480940 Above and Beyond Care Providers Exclusive Provider Organization 2136 E. Bowker St, Phoenix, AZ 85040 2014-09-18
1578979118 White Mountain Surgical Specialist Exclusive Provider Organization 2650 E Show Low Lake Rd Ste 2, Show Low, AZ 85901-7955 2014-07-03
1023441987 New Life Care Center Int Exclusive Provider Organization 650 S Country Club Dr Apt 125, Mesa, AZ 85210-2341 2013-08-14
1902246291 Steven R Holt Od Pllc Exclusive Provider Organization 15341 W Waddell Rd Ste 106, Surprise, AZ 85379-5169 2013-07-01
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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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