Provider Demographics
NPI:1255501565
Name:WINSLOW INDIAN HEALTH CARE GROUP
Entity Type:Organization
Organization Name:WINSLOW INDIAN HEALTH CARE GROUP
Other - Org Name:WINSLOW MEMORIAL HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OF MEDICAL STAFF
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-289-4646
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:AZ
Mailing Address - Zip Code:86047-0400
Mailing Address - Country:US
Mailing Address - Phone:928-289-4646
Mailing Address - Fax:928-289-6289
Practice Address - Street 1:1501 N WILLIAMSON AVE
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:AZ
Practice Address - Zip Code:86047-2735
Practice Address - Country:US
Practice Address - Phone:928-289-4691
Practice Address - Fax:928-289-6289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINSLOW INDIAN HEALTH CARE CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-04
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ728701Medicaid
AZ758542Medicaid
AZ728727Medicaid
AZ758526Medicaid
AZ728719Medicaid
AZ739089Medicaid
AZ758518Medicaid
AZ758518Medicaid