Grapevine Clinic Llc

LBN: Grapevine Clinic Llc
Grapevine Clinic Llc is an health care organization with primary practice located at 5300 S Highway 95 Suite H, Fort Mohave AZ 86426-9251. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Grapevine Clinic Llc can be contacted via phone (928) 788-6060, or through Cunningham, Kaye A via phone (928) 788-6060.

Contact Information

Primary practice address
5300 S Highway 95 Suite H Fort Mohave AZ 86426-9251
Phone: (928) 788-6060
Fax: (928) 788-6062
Website:
Map and Directions
Authorized official contact:
Name: Cunningham, Kaye A Doctor of Medicine (MD)
Phone: (928) 788-6060

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 28326 Arizona

Profile Details

NPI number 1164731030
LBN Legal business name Grapevine Clinic Llc
DBA Doing business as
Authorized official Cunningham, Kaye A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 27th, 2010
Last updated Sep 27th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164731030 NPPES
Arizona Other L-16288258 ARIZONA LLC REGISTRATION

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