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General NPI Number Information
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NPI Number | 1659837615
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Entity Type | Organization
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Legal Business Name | DILKON MEDICAL CENTER PHARMACY
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DRIVE
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City | DILKON
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State | AZ
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Zip | 86047
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Country | US
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Telephone | 928-289-4646
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Fax | 928-289-6290
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Provider Business Mailing Address
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Address Line | 500 INDIANA AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2169
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Country | US
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Telephone | 928-289-4646
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Fax | 928-289-6290
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. VIRGIL DAVIS
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Credential | CEO
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Telephone | 928-289-4646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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