Organization
HUALAPAI MOUNTAIN MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD J FENTEM (VP, REVENUE CYCLE MANAGEMENT)
(972) 702-7500
Entity
Organization
Contact information
Practice address
3801 SANTA ROSA, KINGMAN, AZ 86401-2311
(928) 757-2907
(928) 757-2931
Mailing address
PO BOX 843719, DALLAS, TX 75284-3719
(928) 757-2907
(928) 757-2931
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
05/22/2009
Last updated
01/24/2012
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