GILA VALLEY CLINIC PC; NPI #1740767664

Contact Information

GILA VALLEY CLINIC PC

1680 S 20TH AVE
SAFFORD, AZ 85546

Phone: 928-428-1377
Fax: 928-428-6903
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for GILA VALLEY CLINIC PC

NPI # 1740767664

LBN Legal business name GILA VALLEY CLINIC PC

Authorized official DONNA COCA - (BUSINESS MANAGER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 07/24/2018

Last updated 09/07/2018 - About 8 years ago

Identifiers

Medicaid

121963

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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