Dhhs Ihs Phoenix Area | |
943 Hualapai Way Peach Springs AZ 86434-0190 | |
(928) 769-2900 | |
(928) 769-2701 |
Full Name | Dhhs Ihs Phoenix Area |
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Speciality | Clinic/center - Dental |
Location | 943 Hualapai Way, Peach Springs, Arizona |
Authorized Official Name and Position | Rosemary Sullivan (HEALTH SYSTEM ADMINISTRATOR) |
Authorized Official Contact | 9287692900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dhhs Ihs Phoenix Area Po Box 190 Peach Springs AZ 86434-0190 Ph: (928) 769-2900 | Dhhs Ihs Phoenix Area 943 Hualapai Way Peach Springs AZ 86434-0190 Ph: (928) 769-2900 |
NPI Number | 1447431804 |
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Provider Enumeration Date | 11/14/2007 |
Last Update Date | 03/30/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447431804 | NPI | - | NPPES |
092411 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |