Provider Demographics
NPI:1851538805
Name:SIERRA VISTA REGIONAL HEALTH CENTER INC
Entity Type:Organization
Organization Name:SIERRA VISTA REGIONAL HEALTH CENTER INC
Other - Org Name:SIERRA VISTA REGIONAL HEALTH CENTER INC PROFESSIONAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:520-417-3001
Mailing Address - Street 1:PO BOX 2289
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2289
Mailing Address - Country:US
Mailing Address - Phone:928-634-0665
Mailing Address - Fax:928-634-0337
Practice Address - Street 1:300 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2812
Practice Address - Country:US
Practice Address - Phone:520-417-4994
Practice Address - Fax:520-417-4979
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA VISTA REGIONAL HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-13
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH0119282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital