MEDICARE: GILA RIVER HEALTH CARE CORPORATION

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	282NC0060X	Critical Access Hospital		AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1376538231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILA RIVER HEALTH CARE CORPORATION

Provider Business Mailing Address
First Line	:	P.O. BOX 38
Second Line	:
City	:	SACATON
State	:	AZ
Zip	:	85147-0038
Country	:	US
Telephone Number	:	602-528-1200
Fax Number	:	602-528-1255

Provider Business Practice Location Address
First Line	:	17487 S. HEALTH CARE DR.
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-0038
Country	:	US
Telephone Number	:	520-550-6000
Fax Number	:	520-550-6027

Authorized Official
Title or Position	:	CEO
Name	:	DR. ANTHONY J SANTIAGO
Credential	:
Telephone Number	:	602-528-1200

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	06/17/2025

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