DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM NPI 1508887993

NPI Information

DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM is a public health and federal clinic center in Fort Duchesne, UT. DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM NPI is 1508887993. The provider is registered as an organization entity type.
The provider Is Doing Business As Fort Duchesne Phs Indian Health Center.

The provider's business location address is:

6822 EAST 1000 SOUTH
FORT DUCHESNE PHS INDIAN HEALTH CENTER
FORT DUCHESNE, UT
ZIP 84026
Phone: (435) 722-5122
Fax: (435) 722-9137

The provider's authorized official is Delbert Gary Martin .
The authorized official title is Chief Pharmacist and has the following contact phone number (435) 725-6874.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 4/4/2013.

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:

Other Identifiers

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

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