Healthcare Provider Details

I. General information

NPI: 1376538231
Provider Name (Legal Business Name): GILA RIVER HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17487 S. HEALTH CARE DR.
LAVEEN AZ
85339-0038
US

IV. Provider business mailing address

P.O. BOX 38
SACATON AZ
85147-0038
US

V. Phone/Fax

Practice location:
  • Phone: 520-550-6000
  • Fax: 520-550-6027
Mailing address:
  • Phone: 602-528-1200
  • Fax: 602-528-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateAZ

VIII. Authorized Official

Name: DR. ANTHONY J SANTIAGO
Title or Position: CEO
Credential:
Phone: 602-528-1200