Organization
HAVASU REGIONAL MEDICAL CENTER, LLC
Active
Organization
HAVASU REGIONAL MEDICAL CENTER, LLC
Active
Other names
Havasu Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY J. TEAGUE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 855-8185
(928) 505-5768
Mailing address
103 POWELL CT, STE. 200, BRENTWOOD, TN 37027-5079
(615) 372-8500
(615) 372-8572
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510017
—
AZ
Enumeration date
11/01/2006
Last updated
07/26/2019
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