COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS
NPI 1790182871
Clinic/Center in Douglas, AZ
NPI Status: Active since December 04, 2014
Contact Information
100 E 5TH ST
DOUGLAS, AZ
ZIP 85607
Phone: (520) 364-7659
- Organization
- Clinic/Center
- CLIA Number: 03D0969812
- CLIA Cert. Type: Rural Health Clinic
- CLIA Exp. Date: 08-01-2027
About COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS
This page provides the complete NPI Profile along with additional information for Copper Queen Medical Associates-douglas, a provider established in Douglas, Arizona operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1790182871 assigned on December 2014. The practitioner's primary taxonomy code is 261Q00000X with license number H0098 (AZ). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Copper Queen Medical Associates-douglas. The authorized official of this NPI record is James Dickson (Ceo)
- NPI
- 1790182871
- Provider Legal Name
- BISBEE HOSPITAL ASSOCIATION
- Other Organization Name
- COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 100 E 5TH ST DOUGLAS, AZ 85607
- Location Phone
- (520) 364-7659
- Mailing Address
- 100 E 5TH ST DOUGLAS, AZ 85607
- Mailing Phone
- (520) 364-7659
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-04-2014
- Last Update Date
- 12-04-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- H0098
- License State
- AZ
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D0969812
- Facility Type
- Rural Health Clinic
- Certificate Effective Date
- August 02, 2025
- Certificate Expiration Date
- August 01, 2027
- Laboratory Director
- MAX MIROT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Copper Queen Medical Associates-douglas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1790182871, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
DOUGLAS, AZ 85607
DOUGLAS, AZ 85607
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790182871, enumerated as an "organization" on December 04, 2014.
The provider is located at 100 E 5TH ST DOUGLAS, AZ 85607 and the phone number is (520) 364-7659.
Clinic/Center with taxonomy code 261Q00000X.
