1033437884 NPI number — GILA RIVER HEALTH CARE CORPORTION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033437884 NPI number — GILA RIVER HEALTH CARE CORPORTION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GILA RIVER HEALTH CARE CORPORTION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033437884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
483 W. SEED FARM RD.
Provider Second Line Business Mailing Address:
CREDENTIALING
Provider Business Mailing Address City Name:
SACATON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85147-0115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-528-1340
Provider Business Mailing Address Fax Number:
602-528-1296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
483 W. SEED FARM RD.
Provider Second Line Business Practice Location Address:
CREDENTIALING
Provider Business Practice Location Address City Name:
SACATON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85147-0115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-528-1340
Provider Business Practice Location Address Fax Number:
602-528-1296
Provider Enumeration Date:
05/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SCHEMBURGER
Authorized Official First Name:
KAYLOR
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
602-528-1200

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  TRIBAL , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com