Organization
COBRE VALLEY REGIONAL MEDICAL CENTER
Active
Other names
Superior Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NEAL D. JENSEN (CEO)
(928) 425-3261
Entity
Organization
Contact information
Practice address
1134 W US HIGHWAY 60, SUPERIOR, AZ 85173
(520) 689-2423
(520) 689-5237
Mailing address
1134 W US HIGHWAY 60, SUPERIOR, AZ 85173-3400
(520) 689-2423
(520) 689-5237
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H0126
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649245135
NPI
AZ
05
—
934467
—
AZ
Enumeration date
02/20/2006
Last updated
08/09/2018
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