Healthcare Provider Details

I. General information

NPI: 1588660104
Provider Name (Legal Business Name): UNITED INDIAN HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 LUCAS ST
EUREKA CA
95501-3340
US

IV. Provider business mailing address

1600 WEEOT WAY
ARCATA CA
95521-4734
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-5000
  • Fax:
Mailing address:
  • Phone: 707-825-5000
  • Fax: 707-825-6747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CECIL PAUL WILSON
Title or Position: CFO
Credential:
Phone: 707-825-4065