Provider Demographics
NPI:1699282301
Name:IHS SHINNECOCK SERVICE UNIT
Entity type:Organization
Organization Name:IHS SHINNECOCK SERVICE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SYSTEM ADMIN/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-283-1446
Mailing Address - Street 1:PO BOX 5081
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11969-5081
Mailing Address - Country:US
Mailing Address - Phone:631-283-1446
Mailing Address - Fax:631-283-1448
Practice Address - Street 1:101 CHURCH STREET
Practice Address - Street 2:LL
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968
Practice Address - Country:US
Practice Address - Phone:631-283-1446
Practice Address - Fax:631-283-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare