Organization
SOUTHWESTERN MEDICAL CENTERS AZ
Active
Other names
Meadow Park Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
STAN STUDER JR. (PRESIDENT)
(210) 828-5686
Entity
Organization
Contact information
Practice address
864 DOUGHERTY ST, PRESCOTT, AZ 86305-1841
(928) 778-9667
(928) 771-9620
Mailing address
864 DOUGHERTY ST, PRESCOTT, AZ 86305-1841
(928) 778-9666
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
4602
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041088
—
AZ
Enumeration date
10/19/2006
Last updated
07/26/2007
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