| Native American Connections, Inc. | |
|
337 E Virginia Ave Bldg B Phoenix AZ 85004-1220 | |
| (602) 266-4500 | |
| Not Available |
| Full Name | Native American Connections, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 337 E Virginia Ave Bldg B, Phoenix, Arizona |
| Authorized Official Name and Position | John Godfrey (COO) |
| Authorized Official Contact | 6026880350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Native American Connections, Inc. 3216 N 3rd St Phoenix AZ 85012-2682 Ph: (602) 254-3247 | Native American Connections, Inc. 337 E Virginia Ave Bldg B Phoenix AZ 85004-1220 Ph: (602) 266-4500 |
| NPI Number | 1306331509 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 3577905199 |
|---|---|
| Medicare Enrollment ID | O20240529001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306331509 | NPI | - | NPPES |
| Provider Name | Sheeba Kalappurakkal Divakaran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174120489 PECOS PAC ID: 7012326804 Enrollment ID: I20240529001396 |
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