Organization
NORTH COUNTRY HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE M NEWLAND (CEO)
(928) 522-9400
Entity
Organization
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6121
(928) 774-6687
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 522-9400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
OTC 0806
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433079
—
AZ
Enumeration date
05/07/2008
Last updated
06/30/2021
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