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General NPI Number Information
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NPI Number | 1982782256
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Entity Type | Organization
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Legal Business Name | UNITED INDIAN HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 1600 WEEOT WAY
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City | ARCATA
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State | CA
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Zip | 95521-4734
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Country | US
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Telephone | 707-825-5020
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Fax | 707-825-6879
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Provider Business Mailing Address
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Address Line | 1600 WEEOT WAY
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City | ARCATA
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State | CA
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Zip | 95521-4734
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Country | US
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Telephone | 707-825-4177
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Fax | 707-825-6879
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | KANAKO MIYAMOTO
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Credential |
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Telephone | 707-825-4095
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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 | 45313
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License Number State | CA
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