NPI 1497038871

Goodwill Industries -Cottonwood

Organisation Exclusive Provider Organization Cottonwood, AZ

Practice location

Address: 1500 E Mingus Ave, Cottonwood, AZ 86326-3849
Phone: (928) 526-9188
Mailing address: PO Box 2278, Flagstaff, AZ 86003-2278

Authorised official

Name: Jordan Hoffman
Title: Director
Phone: (928) 526-9188

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1497038871
Entity type: Organization
NPI issued: 22 Sep 2011
Record last updated: 22 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.