NPIMap

Organization Active NPI

Sacred Peaks Health Center DME

Doing business as Sacred Peaks Health Center

  • Durable Medical Equipment & Medical Supplies
  • Flagstaff, AZ
National Provider Identifier
1184045916
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SACRED PEAKS HEALTH CENTER DME
Doing business as
Sacred Peaks Health Center
Practice address
6300 N Highway 89
Flagstaff, AZ 86004
Phone
(928) 863-7333
Fax
(928) 525-0047
NPI assigned
Dec 20, 2013
Last updated
Sep 10, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynette Bonar
Title
Chief Executive Officer
Phone
(928) 283-2944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

6300 N Highway 89
Flagstaff, AZ 86004

Mailing address

PO Box 600
167 North Main Street
Tuba City, AZ 86045-0600
Phone (928) 283-2781

Other names 1

  • Sacred Peaks Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tuba City Regional Health Care Center39 organizations share this tax ID, including this one
Part of
Tuba City Regional Health Care Center

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1184045916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "address_2": "167 NORTH MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2781",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N HIGHWAY 89",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86004",
            "telephone_number": "928-863-7333",
            "fax_number": "928-525-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED PEAKS HEALTH CENTER DME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUBA CITY REGIONAL HEALTH CARE CORPORATION",
        "enumeration_date": "2013-12-20",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "BONAR",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-283-2944"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Peaks Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sacred Peaks Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.