Provider Demographics
NPI:1912955220
Name:YUMA HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:YUMA HEALTH CARE SERVICES, INC
Other - Org Name:DBA. YUMA REGIONAL FIRST HEALTH MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WALZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-336-7275
Mailing Address - Street 1:2451 SOUTH AVENUE A
Mailing Address - Street 2:BLDG B, SUITE 101
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-317-0040
Mailing Address - Fax:928-317-0131
Practice Address - Street 1:2451 SOUTH AVENUE A
Practice Address - Street 2:BLDG B, SUITE 101
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364
Practice Address - Country:US
Practice Address - Phone:928-317-0040
Practice Address - Fax:928-317-0131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YUMA HEALTH CARE SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0275770OtherPROVIDER NUMBER BLUE CROS
AZ1146310001Medicare NSC