CANYONLANDS COMMUNITY HEALTH CARE NPI 1619945904

NPI Information

CANYONLANDS COMMUNITY HEALTH CARE is a community health clinic center in Page, AZ. CANYONLANDS COMMUNITY HEALTH CARE NPI is 1619945904. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lake Powell Medical Center.

The provider's business location address is:

467 VISTA AVENUE
PAGE, AZ
ZIP 86040-625
Phone: (928) 645-8123
Fax: (928) 645-3862

The provider's authorized official is Christopher J Hansen .
The authorized official title is Ceo and has the following contact phone number (928) 645-9675.

The CLIA number assigned to this NPI record is 03D0533867 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/10/2006 and was last updated on 9/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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