| NPI | 1215585807 |
|---|---|
| Doing Business As | PETRIFIED FOREST MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JUSTIN HICKMAN President And CEO 302-724-6217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QU0200X Clinic/Center, Urgent Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-09-18 |