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NPI Code Detail

MEDICARE: DHHS, PHS, NAIHS, SHIPROCK HOSPITAL

MEDICARE: DHHS, PHS, NAIHS, SHIPROCK HOSPITAL
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
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114141876
Entity Type Code : Organization
Provider Name (Legal Business Name) : DHHS, PHS, NAIHS, SHIPROCK HOSPITAL
Provider Business Mailing Address
First Line : 6 ROAD 7586
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-4934
Country : US
Telephone Number : 505-368-6401
Fax Number : 505-368-6431
Provider Business Practice Location Address
First Line : 6 ROAD 7586
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-4934
Country : US
Telephone Number : 505-368-6001
Fax Number : 505-368-6431
Authorized Official
Title or Position : CEO
Name : FANNESSA COMER
Credential :
Telephone Number : 505-368-6006
Provider Enumeration Date : 04/12/2007
Last Update Date : 12/05/2008

Similar Medicare Providers

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Practice Location Address:
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1316938996 — MRS. ARIEL ROSE HOWARD LBSW
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1699766287 — THOMAS WILLIAM HURST OD
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1437134046 — DEANNA DEVORE LMSW
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1396851127 — DR. BRYAN WAYNE HARBER D.D.S.
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1336278597 — DHHS PHS NAIHS SHIPROCK HOSPITAL
Practice Location Address:
6 ROAD 7586
BLOOMFIELD, NM
87413-4934
Practice Phone: 505-368-8144
Practice Fax: 505-368-8009

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