Hildale Health Services LLC

Organization Active NPI Clinic/Center · Colorado City, AZ

NPI 1336536770 · NPPES record last updated Apr 23, 2015

Key facts

NPI
1336536770
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
AP4846 (AZ)
Legal business name
HILDALE HEALTH SERVICES LLC
Practice address
20 South Colvin Street
Colorado City, AZ 86021-0459
Phone
(435) 633-6750
Fax
(435) 201-8680
NPI assigned
Apr 23, 2015
Organization subpart
No

Authorized official

Name
Ezra L Nielsen
Title
Owner
Phone
(435) 633-6750

Corporate family (same tax ID) 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Hildale Health Services LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AP4846 AZ Yes

Addresses

Primary practice location

20 South Colvin Street
Colorado City, AZ 86021-0459

Mailing address

PO Box 459
Colorado City, AZ 86021-0459
Phone (435) 633-6750

Other providers in Colorado City, AZ

All providers in Colorado City, AZ · Clinic/Center in Arizona

Sources for this page

Verify at the official NPI Registry.