MEDICARE: UNITED INDIAN HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1588660104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED INDIAN HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1600 WEEOT WAY
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-4734
Country	:	US
Telephone Number	:	707-825-5000
Fax Number	:	707-825-6747

Provider Business Practice Location Address
First Line	:	2505 LUCAS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-3340
Country	:	US
Telephone Number	:	707-825-5000
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CECIL PAUL WILSON
Credential	:
Telephone Number	:	707-825-4065

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	05/13/2024

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