Organization Name: | DHHS, PHS, NAIHS, SHIPROCK HOSPITAL |
NPI Number: | 1235312315 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FANNESSA COMER (CEO) |
Mailing Address: | Us Highway 491 North Shiprock |
State: | NM US |
Postal Code: | 87420 |
Phone Number: | 5053686401 |
Fax Number: | 5053686431 |
NPI Enumeration Date: | 12/11/2007 |
NPI Last Update Date: | 12/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |