LA PAZ REGIONAL HOSPITAL INC. NPI 1629093539

NPI Information

NPI: 1629093539
Provider Name: LA PAZ REGIONAL HOSPITAL, INC.

Doing Business As: TRI-VALLEY MEDICAL CENTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
39726 HARQUAHALA ROAD
SALOME, AZ
ZIP 85348
Phone: (928) 859-3460
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LA PAZ REGIONAL HOSPITAL, INC. is a rural health clinic center in Salome, AZ. LA PAZ REGIONAL HOSPITAL, INC. NPI is 1629093539. The provider is registered as an organization entity type.
The provider Is Doing Business As Tri-valley Medical Center.

The provider's business location address is:

39726 HARQUAHALA ROAD
SALOME, AZ
ZIP 85348
Phone: (928) 859-3460
Fax: (928) 859-3475

The provider's authorized official is Kevin Brown .
The authorized official title is Ceo and has the following contact phone number (928) 669-7300.

The CLIA number assigned to this NPI record is 03D1039169 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 6/6/2017.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	H0138	ARIZONA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	480046	MEDICAID	ARIZONA
2	CG7880	OTHER	ARIZONA	MEDICARE RR
3	033994	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA
4	ZP03006701	MEDICARE PIN	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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