NPI 1144382219

Phoenix Indian Medical Center

Organisation Public Health or Welfare Agency Phoenix, AZ

Practice location

Address: 4212 N 16th St, Phoenix, AZ 85016-5319
Phone: (602) 296-4750
Fax: (602) 263-1621
Mailing address: 6414 S 26th Ave, Phoenix, AZ 85041-5365

Authorised official

Name: Velliyah Ellen Craig
Title: Pharmacist
Phone: (602) 263-1200

Registered specialties

Public Health or Welfare Agency Primary

Agencies Taxonomy 251K00000X Licence RP00005927 (NM)

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Registry record

NPI: 1144382219
Entity type: Organization
NPI issued: 15 Dec 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.