Provider Demographics
NPI:1861791667
Name:DHHS PHS NAIHS INSCRIPTION HOUSE HEALTH CENTER
Entity type:Organization
Organization Name:DHHS PHS NAIHS INSCRIPTION HOUSE HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-697-4234
Mailing Address - Street 1:HWY 98 NAVAJO ROUTE 16
Mailing Address - Street 2:
Mailing Address - City:SHONTO
Mailing Address - State:AZ
Mailing Address - Zip Code:86054-7397
Mailing Address - Country:US
Mailing Address - Phone:928-672-3000
Mailing Address - Fax:
Practice Address - Street 1:HWY 98 NAVAJO ROUTE 16
Practice Address - Street 2:
Practice Address - City:SHONTO
Practice Address - State:AZ
Practice Address - Zip Code:86054-7397
Practice Address - Country:US
Practice Address - Phone:928-672-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ030084Medicare Oscar/Certification