Healthcare Provider Details

I. General information

NPI: 1619001849
Provider Name (Legal Business Name): RAMAH NAVAJO SCHOOL BOARD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 09/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 BIA 120 PO BOX 310
PINE HILL NM
87357-0310
US

IV. Provider business mailing address

PO BOX 310
PINE HILL NM
87357-0310
US

V. Phone/Fax

Practice location:
  • Phone: 505-775-3271
  • Fax: 505-775-3233
Mailing address:
  • Phone: 505-775-3271
  • Fax: 505-775-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNM

VIII. Authorized Official

Name: MR. WILLIAM BECKER
Title or Position: CHIEF HEALTH ADMINISTRATOR
Credential:
Phone: 505-775-3271