Organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Active
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Other names
Sacred Peaks Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Authorized official
LYNETTE BONAR (CHIEF EXECUTIVE OFFICER)
(928) 283-2944
Entity
Organization
Contact information
Practice address
6300 N HIGHWAY 89, FLAGSTAFF, AZ 86004
(928) 863-7333
(928) 525-0047
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
225100000X
Physical Therapist
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721250
—
AZ
Enumeration date
07/23/2009
Last updated
09/10/2019
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