Organization Name: | STATCLINIX PLC |
NPI Number: | 1093812083 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY MCGUIRE (COO) |
Mailing Address: | 680 E Deuce Of Clubs Suite B Show Low |
State: | AZ US |
Postal Code: | 859014827 |
Phone Number: | 9285372777 |
Fax Number: | 9285372787 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 04/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | OTC 3916 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |