Phoenix Indian Medical Center

LBN: Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm
Phoenix Indian Medical Center is an health care organization with primary practice located at 4212 N 16Th St , Phoenix AZ 85016-5319. The organization recently has only one registered license in Agencies / Public Health or Welfare, which is considered as the primary health care specialty. Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm can be contacted via phone (602) 263-1200, or through Tillman, Laura A via phone (602) 581-6080.

Contact Information

Primary practice address
4212 N 16Th St Phoenix AZ 85016-5319
Fax: (602) 200-5383
Website:
Authorized official contact:
Name: Tillman, Laura A Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X

Profile Details

NPI number 1083643738
LBN Legal business name Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm
DBA Doing business as Phoenix Indian Medical Center
Authorized official Tillman, Laura A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 2nd, 2006
Last updated Mar 19th, 2024 - about 8 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083643738 NPPES
Arizona MEDICAID 537821
Arizona Other P0206550
Arizona MEDICAID 418196
Arizona MEDICAID 022062
Arizona MEDICAID 092354

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