Mountain Vista Medical Center, LP

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

MOUNTAIN VISTA MEDICAL CENTER, LP

Practice address

4545 N Hunt Hwy
Florence, AZ 85132-6937

Phone

(520) 868-3333

NPI assigned

Nov 19, 2018

Organization subpart

No

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

Authorized official

Name

Jacob Golich

Title

Hospital President

Phone

(480) 358-6100

Specialties & licenses 1

Addresses

Other names 1

• FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 030132

Legal name

FLORENCE HOSPITAL AT ANTHEM, LLC

Certification status

Terminated Voluntary: merger or closure, Jun 18, 2018

Provider type (POS)

Hospital – Short-term

Participating since

May 1, 2012

Last certification

Apr 19, 2018

Beds

36

Ownership / control type

Private (for profit)

Facility address

4545 North Hunt Highway
Florence, AZ 85132

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1609345685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "480-358-6100",
            "fax_number": "480-358-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 N HUNT HWY",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851326937",
            "telephone_number": "520-868-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA MEDICAL CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "GOLICH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "HOSPITAL PRESIDENT",
        "authorized_official_telephone_number": "480-358-6100"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Acute Care Hospital in Florence, AZ
• Providers in Florence, AZ by specialty
• General Acute Care Hospital in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.