San Carlos Apache Tribe is a
Dietitian, Registered based in San Carlos, Arizona. San Carlos Apache Tribe is licensed to practice in Arizona (license number 85002233) and their current practice location is
1 Mohave Avenue, San Carlos, Arizona. It can be reached at their office (for appointments etc.) via phone at
(928) 475-2798.
NPI number for San Carlos Apache Tribe is 1912030370 and their current mailing address is Po Box 0, San Carlos, Arizona. San Carlos Apache Tribe
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1912030370.
Healthcare Provider's Profile
Full Name | San Carlos Apache Tribe |
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Type | Facility |
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Speciality | Dietitian, Registered |
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Location | 1 Mohave Avenue, San Carlos, Arizona |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1912030370
- Provider Enumeration Date: 03/14/2007
- Last Update Date: 08/22/2020
Medical Identifiers
Medical identifiers for San Carlos Apache Tribe such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912030370 | NPI | - | NPPES |
153159 | Medicaid | AZ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 85002233 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. San Carlos Apache Tribe is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
San Carlos Apache Tribe Po Box 0, San Carlos, AZ 85550 Ph: (928) 475-2798 | San Carlos Apache Tribe 1 Mohave Avenue, San Carlos, AZ 85550 Ph: (928) 475-2798 |
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