Healthcare Provider Details

I. General information

NPI: 1548546609
Provider Name (Legal Business Name): DHHS IHS PHOENIX AREA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2011
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 MOUNTAIN VIEW DR
BATTLE MOUNTAIN NV
89820-1862
US

IV. Provider business mailing address

515 SHOSHONE CIR
ELKO NV
89801-5072
US

V. Phone/Fax

Practice location:
  • Phone: 775-635-8200
  • Fax:
Mailing address:
  • Phone: 775-738-2252
  • Fax: 775-748-1455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHY E WELCHERT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 775-738-2252