Provider Demographics
NPI:1255011920
Name:FAMILY HEALTHCARE OF YUMA
Entity type:Organization
Organization Name:FAMILY HEALTHCARE OF YUMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:WOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-258-2207
Mailing Address - Street 1:2946 S AVENUE B
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7704
Mailing Address - Country:US
Mailing Address - Phone:928-275-3213
Mailing Address - Fax:
Practice Address - Street 1:2589 E 24TH ST STE 2
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-3226
Practice Address - Country:US
Practice Address - Phone:928-275-3213
Practice Address - Fax:928-268-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty