Provider Demographics
NPI:1629452917
Name:CHEROKEE INDIAN HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:CHEROKEE INDIAN HOSPITAL AUTHORITY
Other - Org Name:CIHA EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:CERI
Authorized Official - Last Name:DANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-497-9163
Mailing Address - Street 1:1 HOSPITAL RD
Mailing Address - Street 2:CALLER BOX C-268
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9253
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:CALLER BOX C-268
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719-9253
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-1723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE INDIAN HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-16
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
NC261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0767COtherBCBSNC
NC1770662348Medicaid
NCTRZ010Medicare PIN
NC1770662348Medicaid
NC340156Medicare PIN