Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Parent organization
CANYONDLANDS COMMUNITY HEALTH CARE
Other names
Lake Powell Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANYONDLANDS COMMUNITY HEALTH CARE
Authorized official
CHRISTOPHER J HANSEN (CEO)
(928) 645-9675
Entity
Organization
Contact information
Practice address
467 VISTA AVENUE, PAGE, AZ 86040-1625
(928) 645-8123
(928) 645-3862
Mailing address
PO BOX 1625, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-3030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
OTC 0127
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432857
—
AZ
Enumeration date
03/10/2006
Last updated
09/23/2021
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