Healthcare Provider Details

I. General information

NPI: 1427231604
Provider Name (Legal Business Name): GILA RIVER HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 05/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 W. SEED FARM RD.
SACATON AZ
85147-0038
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 602-528-1200
  • Fax: 602-528-1255
Mailing address:
  • Phone: 602-528-1200
  • Fax: 602-528-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberNA - TRIBAL
License Number StateAZ

VIII. Authorized Official

Name: SCOTT GEMBERLING
Title or Position: CEO
Credential:
Phone: 602-528-1470