Provider Demographics
NPI:1821273475
Name:TOHONO O'ODHAM NATION- DHS
Entity Type:Organization
Organization Name:TOHONO O'ODHAM NATION- DHS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-383-2028
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:SELLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85634-0810
Mailing Address - Country:US
Mailing Address - Phone:520-383-6050
Mailing Address - Fax:520-383-6065
Practice Address - Street 1:ST. RTE.86-MULTIHEALTH COMPLEX TRANSPORTATION SERVICES
Practice Address - Street 2:
Practice Address - City:SELLS
Practice Address - State:AZ
Practice Address - Zip Code:85634
Practice Address - Country:US
Practice Address - Phone:520-383-6050
Practice Address - Fax:520-383-6065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ440157OtherINDIAN HEALTH SERVICE
AZ442012OtherINDIAN HEALTH SERVICE