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1043216021

NPI Code Detail

MEDICARE: UNITED INDIAN HEALTH SERVICES, INC.

MEDICARE: UNITED INDIAN HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist
2	251S00000X	Community/Behavioral Health Agency
3	261QC1500X	Community Health Clinic/Center	EXEMPT	CA
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1043216021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED INDIAN HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1600 WEEOT WAY
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-4734
Country	:	US
Telephone Number	:	707-825-5000
Fax Number	:	707-825-6747

Provider Business Practice Location Address
First Line	:	1675 NORTHCREST DR
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-8928
Country	:	US
Telephone Number	:	707-464-2750
Fax Number	:	707-464-2668

Authorized Official
Title or Position	:	CFO
Name	:	CECIL PAUL WILSON
Credential	:
Telephone Number	:	707-825-4065

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	11/16/2022

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Directions to “UNITED INDIAN HEALTH SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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