Healthcare Provider Details

I. General information

NPI: 1346566197
Provider Name (Legal Business Name): UINTAH & OURAY INDIAN HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6822 E 1000 S
FT DUCHESNE UT
84026
US

IV. Provider business mailing address

1727 W 500 S
VERNAL UT
84078-3913
US

V. Phone/Fax

Practice location:
  • Phone: 435-725-6850
  • Fax:
Mailing address:
  • Phone: 435-790-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number3441733102
License Number StateUT

VIII. Authorized Official

Name: MS. DEBORAH LEE HORROCKS
Title or Position: REGISTERED NURSE
Credential: REGISTERED NURSE
Phone: 435-725-6850