Provider Demographics
NPI:1578840203
Name:DHHS IHS PHOENIX AREA
Entity Type:Organization
Organization Name:DHHS IHS PHOENIX AREA
Other - Org Name:SHERMAN INDIAN HIGH SCHOOL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-669-2137
Mailing Address - Street 1:9010 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4431
Mailing Address - Country:US
Mailing Address - Phone:951-509-8914
Mailing Address - Fax:
Practice Address - Street 1:9010 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4431
Practice Address - Country:US
Practice Address - Phone:951-509-8914
Practice Address - Fax:928-669-3232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKER INDIAN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health