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Organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Active
Organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Active
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Other names
Sacred Peaks Health Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Authorized official
LYNETTE BONAR (CHIEF EXECUTIVE OFFICER)
(928) 283-2944
Entity
Organization
Contact information
Practice address
6300 N HIGHWAY 89, FLAGSTAFF, AZ 86004
(928) 863-7331
(928) 526-5900
Mailing address
6300 N HIGHWAY 89, FLAGSTAFF, AZ 86004
(928) 863-7331
(928) 526-5900
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0357257
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
721250
—
AZ
Enumeration date
09/02/2011
Last updated
09/10/2019
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