COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS
NPI 1790182871
Clinic/Center in Douglas, AZ

Active since December 04, 2014CLIA 03D0969812 · Waiver
100 E 5TH ST, DOUGLAS, AZ 85607(520) 364-7659 Get Directions Write a Review

NPPES record last updated: December 4, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Copper Queen Medical Associates-douglas NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COPPER QUEEN MEDICAL ASSOCIATES-DOUGLAS (NPI 1790182871) is a healthcare organization registered as a clinic/center in Douglas, Arizona and active in the NPI registry since December 2014. The organization holds a CLIA Waiver certificate valid through August 1, 2027 and lists James Dickson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1790182871
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameBISBEE HOSPITAL ASSOCIATION
Location Address100 E 5TH STDouglas, AZ 85607-2859
Mailing Address100 E 5th StDouglas, AZ 85607-2859 · (520) 364-7659
Organization SubpartNo
Authorized OfficialJames DicksonCeo · (520) 432-6400
Enumeration DateDecember 4, 2014
NPI 1790182871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License Licensed in AZ · H0098
Definition

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).

100 E 5TH ST, Douglas, AZ 85607

Other Names 1

Doing Business AsCopper Queen Medical Associates-douglas

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0969812

Copper Queen Medical Associates - Douglas · Douglas, AZ
Active · expires Aug 1, 2027
CLIA Number03D0969812
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 2, 2025
Certificate Expiration DateAugust 1, 2027
Laboratory DirectorMax Mirot
Laboratory Phone(520) 432-6587
Laboratory LocationCopper Queen Medical Associates - Douglas100 E Fifth St Bldg B, Douglas, AZ 85607
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
100 E 5TH ST
DOUGLAS, AZ 85607
Internal Medicine
100 E 5TH ST
DOUGLAS, AZ 85607
General Practice
100 E 5TH ST, CQCH BILLING DEPT
DOUGLAS, AZ 85607
Internal Medicine (Nephrology)
100 E 5TH ST
DOUGLAS, AZ 85607
Nurse Practitioner (Family)
100 E 5TH ST
DOUGLAS, AZ 85607
Nurse Practitioner (Family)
100 E 5TH ST
DOUGLAS, AZ 85607
Physician Assistant
100 E 5TH ST
DOUGLAS, AZ 85607
General Practice
100 E 5TH ST
DOUGLAS, AZ 85607

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bisbee Hospital Association's NPI number?

The NPI number for Bisbee Hospital Association is 1790182871. It was assigned to this organization in the NPPES registry on December 4, 2014. The provider is doing business as Copper Queen Medical Associates-Douglas.

Where is Bisbee Hospital Association located?

Bisbee Hospital Association is located at 100 E 5th St, Douglas, AZ 85607. The listed phone number is (520) 364-7659.

What is Bisbee Hospital Association's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Bisbee Hospital Association hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0969812) is associated with this NPI, valid through August 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bisbee Hospital Association was last updated on December 4, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.