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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