Provider Demographics
NPI:1972869014
Name:INDIAN HEALTH SERVICES
Entity Type:Organization
Organization Name:INDIAN HEALTH SERVICES
Other - Org Name:CHINLE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISHEKER
Authorized Official - Suffix:
Authorized Official - Credentials:ANP,WHCNP
Authorized Official - Phone:928-674-7001
Mailing Address - Street 1:PO BOX 2359
Mailing Address - Street 2:
Mailing Address - City:CHINLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86503-2359
Mailing Address - Country:US
Mailing Address - Phone:928-674-7001
Mailing Address - Fax:928-674-7008
Practice Address - Street 1:HWY 191 AND HOSPITAL DRIVE
Practice Address - Street 2:CHINLE HOSPITAL
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503
Practice Address - Country:US
Practice Address - Phone:928-674-7001
Practice Address - Fax:928-674-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR091000518284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital