National Provider Identifier Database

GILA VALLEY CLINIC PC
Rural Health


Contact Information

GILA VALLEY CLINIC PC
1680 S 20TH AVE
SAFFORD, AZ85546
Phone: 928-428-1377
Fax: 928-428-6903
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for GILA VALLEY CLINIC PC

NPI Number 1740767664
Legal business name
LBN
GILA VALLEY CLINIC PC
Authorized official DONNA COCA - (BUSINESS MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 07/24/2018
Last updated 09/07/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 121963

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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