Provider Demographics
NPI:1134313232
Name:INDIAN HEALTH SERVICE
Entity Type:Organization
Organization Name:INDIAN HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-565-4441
Mailing Address - Street 1:232 RUSTLING WILLOW COMPLEX D
Mailing Address - Street 2:
Mailing Address - City:TOWAOC
Mailing Address - State:CO
Mailing Address - Zip Code:81334
Mailing Address - Country:US
Mailing Address - Phone:970-565-4441
Mailing Address - Fax:
Practice Address - Street 1:RUSTLING WILLOW
Practice Address - Street 2:COMPLEX D
Practice Address - City:TOWAOC
Practice Address - State:CO
Practice Address - Zip Code:81334-0049
Practice Address - Country:US
Practice Address - Phone:970-565-4441
Practice Address - Fax:970-565-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care