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GILA RIVER HEALTH CARE CORPORATION NPI 1114430147


NPI Information

NPI: 1114430147
Provider Name: GILA RIVER HEALTH CARE CORPORATION

Doing Business As: RED TAIL HAWK HEALTH CENTER PHARMACY

Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
Entity Type: Organization

CLIA Number: 03D2148100

Address:
3042 W. QUEEN CREEK ROAD
CHANDLER, AZ
ZIP 85286
Phone: (602) 528-1200
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GILA RIVER HEALTH CARE CORPORATION is an indian health service tribal urban indian health i t u pharmacy in Chandler, AZ. The provider is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. GILA RIVER HEALTH CARE CORPORATION NPI is 1114430147. The provider is registered as an organization entity type.
The provider Is Doing Business As Red Tail Hawk Health Center Pharmacy.

The provider's business location address is:

3042 W. QUEEN CREEK ROAD
CHANDLER, AZ
ZIP 85286
Phone: (602) 528-1200

The provider's authorized official is Scott Gemberling .
The authorized official title is Ceo and has the following contact phone number (602) 528-1427.

The CLIA number assigned to this NPI record is 03D2148100 - rural health clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/13/2017 and was last updated on 11/13/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1334582MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.