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Contact Information

CANYONLANDS COMMUNITY HEALTH CARE
467 VISTA AVENUE
PAGE, AZ86040
 Phone: 928-645-6620
 Fax: 928-645-6621
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CANYONLANDS COMMUNITY HEALTH CARE

NPI Number 1689021933
LBN Legal business name CANYONLANDS COMMUNITY HEALTH CARE
Authorized official ANDREW LEWANDOWSKI - (DIRECTOR OF PHARMACY, PIC, AO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/17/2016
Last updated 09/23/2021 - About 5 years ago
Identifiers
AZ License # Y006821
AZ Medicaid 174027
UT Medicaid 1689021933
Other 2160535 PK
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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