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
Phone: (602) 263-1200
Fax: (602) 200-5383
Website:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083643738 | NPPES |
| Arizona | MEDICAID | 537821 | |
| Arizona | Other | P0206550 | |
| Arizona | MEDICAID | 418196 | |
| Arizona | MEDICAID | 022062 | |
| Arizona | MEDICAID | 092354 |
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