PONDEROSA FAMILY CARE LLC NPI 1992321723

NPI Information

NPI: 1992321723
Provider Name: PONDEROSA FAMILY CARE, LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 03D2026773

Address:
127 E MAIN ST STE D
PAYSON, AZ
ZIP 85541
Phone: (928) 468-8603
Get Directions

PONDEROSA FAMILY CARE, LLC is a rural health clinic center in Payson, AZ. PONDEROSA FAMILY CARE, LLC NPI is 1992321723. The provider is registered as an organization entity type.

The provider's business location address is:

127 E MAIN ST STE D
PAYSON, AZ
ZIP 85541-646
Phone: (928) 468-8603
Fax: (928) 468-8625

The provider's authorized official is Alan P Michels .
The authorized official title is Physician/owner and has the following contact phone number (928) 468-8603.

The CLIA number assigned to this NPI record is 03D2026773 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2020 and was last updated on 6/17/2020.

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			Yes

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: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »