Organization
MT GRAHAM REGIONAL MEDICAL CENTER INC
Active
Parent organization
MT GRAHAM REGIONAL MEDICAL CENTER INC
Other names
Mt. Graham Regional Medical Center Hospice Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MT GRAHAM REGIONAL MEDICAL CENTER INC
Authorized official
MR. KEITH BRYCE (CFO)
(928) 348-4099
Entity
Organization
Contact information
Practice address
1600 S. 20TH AVE, BLDG. E, SAFFORD, AZ 85546
(928) 348-4063
(928) 348-3868
Mailing address
1600 S. 20TH AVE, BLDG. E, SAFFORD, AZ 85546
(928) 348-4063
(928) 348-3868
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
HSPC-43
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D0886073
CLIA NUMBER
AZ
05
—
317786
—
AZ
01
—
HSPC-43
ADHS NUMBER
AZ
Enumeration date
04/25/2006
Last updated
09/27/2016
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