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Contact Information

COBRE VALLEY REGIONAL MEDICAL CENTER
124 N TEWSKBURY BLVD
YOUNG, AZ85554-0000
 Phone: 928-462-3435
 Fax: 928-462-6644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for COBRE VALLEY REGIONAL MEDICAL CENTER

NPI Number 1497021844
LBN Legal business name COBRE VALLEY REGIONAL MEDICAL CENTER
Authorized official NEAL JENSEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/30/2012
Last updated 01/30/2013 - About 13 years ago
Identifiers
AZ License # H0126
AZ Medicaid 371306
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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