| Dhhs Ihs Phoenix Area | |
|
943 Hualapai Way Peach Springs AZ 86434-0190 | |
| (928) 769-2900 | |
| (928) 769-2701 |
| Full Name | Dhhs Ihs Phoenix Area |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |