Provider Demographics
NPI:1275954000
Name:LECHEE HEALTH FACILITY DME
Entity Type:Organization
Organization Name:LECHEE HEALTH FACILITY DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BONAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-283-2784
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:167 NORTH MAIN STREET
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-0600
Mailing Address - Country:US
Mailing Address - Phone:928-283-2781
Mailing Address - Fax:928-283-2501
Practice Address - Street 1:3 MILES SOUTH OF PAGE, AZ
Practice Address - Street 2:COPPERMINE ROAD
Practice Address - City:LECHEE
Practice Address - State:AZ
Practice Address - Zip Code:86040
Practice Address - Country:US
Practice Address - Phone:928-698-4914
Practice Address - Fax:928-283-2677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUBA CITY REGIONAL HEALTH CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-20
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies