# TUBA CITY REGIONAL HEALTH CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TUBA CITY REGIONAL HEALTH CARE CORPORATION
- **Other names:** Bodaway Gap Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710519913
- **Legal business name:** TUBA CITY REGIONAL HEALTH CARE CORPORATION
- **Authorized official:** LYNETTE BONAR (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (928) 283-2094

## Contact information

- **Practice address:** HWY 89 NORTH MILEPOST 498 EAST, BODAWAY GAP, AZ 86020
- **Practice address phone:** (928) 283-2501
- **Mailing address:** PO BOX 600, TUBA CITY, AZ 86045-0600
- **Mailing address phone:** (928) 283-2501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2020
- **Last updated:** 02/06/2020