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DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM NPI 1396817607


NPI Information

NPI: 1396817607
Provider Name: DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

Doing Business As: SALT RIVER PHARMACY

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

CLIA Number: 03D0719659

Address:
10005 E OSBORN RD
SCOTTSDALE, AZ
ZIP 85256
Phone: (480) 946-9066
Get Directions

DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM is an indian health service tribal urban indian health i t u pharmacy in Scottsdale, 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. DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM NPI is 1396817607. The provider is registered as an organization entity type.
The provider Is Doing Business As Salt River Pharmacy.

The provider's business location address is:

10005 E OSBORN RD
SCOTTSDALE, AZ
ZIP 85256-019
Phone: (480) 946-9066
Fax: (480) 946-9415

The provider's authorized official is Laura A Tillman .
The authorized official title is Cmo and has the following contact phone number (602) 263-1674.

The CLIA number assigned to this NPI record is 03D0719659 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 5/26/2021.


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
1092453MEDICAIDARIZONA
20354679OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

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.