| San Carlos Apache Tribe | |
| 
					1 Mohave Ave San Carlos AZ 85550  | |
| (928) 475-5924 | |
| Not Available | 
| Full Name | San Carlos Apache Tribe | 
|---|---|
| Speciality | Clinic/center | 
| Location | 1 Mohave Ave, San Carlos, Arizona | 
| Authorized Official Name and Position | Wendsler Nosie (TRIBAL CHAIRMAN) | 
| Authorized Official Contact | 9284752361 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| San Carlos Apache Tribe P.o. Box 0 San Carlos AZ 85550 Ph: (928) 475-2361  | San Carlos Apache Tribe 1 Mohave Ave San Carlos AZ 85550 Ph: (928) 475-5924  | 
| NPI Number | 1710055405 | 
|---|---|
| Provider Enumeration Date | 12/01/2006 | 
| Last Update Date | 11/17/2009 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710055405 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary | 
Maternal Child Health Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Bulding 15, San Carlos Ave, San Carlos, AZ 85550 Phone: 928-475-2798  |