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Contact Information

YRMC PHYSICIANCARE INTERNAL MEDICINE
3120 CLEARWATER DR
PRESCOTT, AZ86305-7131
 Phone: 928-771-3704
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

261QP2300X
 

Prison Health

261QP2400X
Indicates primary specialty

NPI Profile & details for YRMC PHYSICIANCARE INTERNAL MEDICINE

NPI Number 1396919387
LBN Legal business name YRMC PHYSICIANCARE INTERNAL MEDICINE
Authorized official DONALD BOLIN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/22/2008
Last updated 10/05/2010 - About 16 years ago
Identifiers
AZ License # 35216
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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