Organization
BLACK CANYON COMMUNITY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY CHARLES HANCOCK DO (CEO)
(623) 374-0200
Entity
Organization
Contact information
Practice address
17301 E SPRING VALLEY RD STE F, MAYER, AZ 86333-4263
(623) 374-0200
(623) 374-5576
Mailing address
PO BOX 12, BLACK CANYON CITY, AZ 85324-0012
(623) 374-0200
(623) 374-5576
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/16/2022
Last updated
12/16/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us