Organization
NORTH COUNTRY HEALTHCARE, INC.
Active
Parent organization
NORTH COUNTRY HEALTHCARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH COUNTRY HEALTHCARE, INC.
Authorized official
ANNE M NEWLAND (CEO)
(928) 522-9400
Entity
Organization
Contact information
Practice address
2600 E. SHOW LOW LAKE RD., SHOW LOW, AZ 85901
(928) 537-4300
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
AZ
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z70394
MEDICARE B PTAN
AZ
Enumeration date
12/06/2012
Last updated
06/30/2021
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