Provider Demographics
NPI:1922783000
Name:WINSLOW INDIAN HEALTH CARE CENTER, INC
Entity Type:Organization
Organization Name:WINSLOW INDIAN HEALTH CARE CENTER, INC
Other - Org Name:DILKON MEDICAL CENTER AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETE
Authorized Official - Suffix:
Authorized Official - Credentials:
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:928-289-6290
Practice Address - Street 1:SWC NAVAJO ROUTE 15& 60
Practice Address - Street 2:
Practice Address - City:DILKON
Practice Address - State:AZ
Practice Address - Zip Code:86047
Practice Address - Country:US
Practice Address - Phone:928-289-4646
Practice Address - Fax:928-289-6290
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINSLOW INDIAN HEALTH CARE CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-16
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport