Healthcare Provider Details

I. General information

NPI: 1497843734
Provider Name (Legal Business Name): ZUNI INDIAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUTE 301 NORTH B STREET
ZUNI NM
87327-0000
US

IV. Provider business mailing address

PO BOX 467
ZUNI NM
87327-0467
US

V. Phone/Fax

Practice location:
  • Phone: 505-782-4431
  • Fax: 505-782-7327
Mailing address:
  • Phone: 505-782-4431
  • Fax: 505-782-7327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEAN OTHOLE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 505-782-7300