Provider Demographics
NPI:1578578951
Name:YUMA HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:YUMA HEALTH CARE SERVICES INC
Other - Org Name:YUMA REGIONAL PLAZA LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-317-0920
Mailing Address - Street 1:1501 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6370
Mailing Address - Country:US
Mailing Address - Phone:928-317-0920
Mailing Address - Fax:928-317-0940
Practice Address - Street 1:1501 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6370
Practice Address - Country:US
Practice Address - Phone:928-317-0920
Practice Address - Fax:928-317-0940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ3D0907326Medicare PIN
AZ690006913Medicare PIN