Provider Demographics
NPI:1659055952
Name:NORTHERN ARIZONA HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:NORTHERN ARIZONA HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-773-2282
Mailing Address - Street 1:1200 N BEAVER ST
Mailing Address - Street 2:ATTN: MANAGED CARE CONTRACTING
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3118
Mailing Address - Country:US
Mailing Address - Phone:928-213-6543
Mailing Address - Fax:
Practice Address - Street 1:450 S WILLARD ST STE 101
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6744
Practice Address - Country:US
Practice Address - Phone:928-634-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN ARIZONA HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty