Provider Demographics
NPI:1174825624
Name:TUBA CITY REGIONAL HEALTH CARE CENTER
Entity Type:Organization
Organization Name:TUBA CITY REGIONAL HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SONOGRAPHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:LIGENZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:928-283-2703
Mailing Address - Street 1:1660 FOOTHILL TER
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1660 FOOTHILL TER
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-6038
Practice Address - Country:US
Practice Address - Phone:928-283-2703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31381282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural