National Provider Identifier Database

NORTH COUNTRY HEALTHCARE INC
Multi-Specialty


Contact Information

NORTH COUNTRY HEALTHCARE INC
2920 N 4TH ST
FLAGSTAFF, AZ86004-1816
Phone: 928-213-6121
Fax: 928-774-6687
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X
Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for NORTH COUNTRY HEALTHCARE INC

NPI Number 1053587261
Legal business name
LBN
NORTH COUNTRY HEALTHCARE INC
Authorized official ANNE NEWLAND - (CEO)
Entity Organization
Organization subpart No
Enumeration date 05/07/2008
Last updated 06/30/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: OTC 0806
  • AZ Medicaid: 433079

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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