Organization
GILA VALLEY CLINIC PC
Active
Parent organization
GILA VALLEY CLINIC PC
Other names
GILA VALLEY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GILA VALLEY CLINIC PC
Authorized official
DONNA S. COCA (BUSINESS MANAGER)
(928) 428-1377
Entity
Organization
Contact information
Practice address
1680 S 20TH AVE, SAFFORD, AZ 85546
(928) 428-1377
(928) 428-6903
Mailing address
1680 S 20TH AVE, SAFFORD, AZ 85546-4011
(928) 428-1377
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121963
—
AZ
Enumeration date
07/24/2018
Last updated
09/07/2018
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