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Organization
BLACK CANYON COMMUNITY HEALTH CENTER, INC.
Active
Organization
BLACK CANYON COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY CHARLES HANCOCK (CEO)
(623) 374-0200
Entity
Organization
Contact information
Practice address
19251 E OASIS DR, BLACK CANYON CITY, AZ 85324-8878
(623) 374-0200
(623) 374-5576
Mailing address
19251 E OASIS DR, BLACK CANYON CITY, AZ 85324-8878
(623) 374-0200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3297
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
397607
—
AZ
Enumeration date
09/19/2008
Last updated
09/23/2026
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