THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION (NPI# 1477876639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477876639 |
| Entity Type | Organization |
| Organization Name | THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION |
| Other Organization Name | FORT DEFIANCE INDIAN HOSPITAL |
| Practice Address |
Corner of Route N12 & N7 Fort Defiance AZ 86504 |
| Mailing Address |
Po Box 649 Fort Defiance AZ 86504-0649 |
| Practice Telephone | 9287298000 |
| Practice Fax Number | 9287298169 |
| Mailing Telephone | 9287298000 |
| Mailing Fax Number | 9287298169 |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2020-08-28 |
| Authorized Official Name | DR. SANDRA ARETINO (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9287298902 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 523053 | 05 | |
| NM | H0010 | 05 |
| Other Name | Type Code |
|---|---|
| Fort Defiance Indian Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487977914 | The Fort Defiance Indian Hospital Board, Incorporation | Clinic/Center | Corner of Route N12 & N7, Fort Defiance, AZ 86504-0649 | 2010-03-11 |
| Street Address |
CORNER OF ROUTE N12 & N7 |
| City | FORT DEFIANCE |
| State | AZ |
| Zip Code | 86504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700962131 | Dhhs Phs Naihs Fort Defiance Hospital | General Acute Care Hospital | Corner of Route N12 & N7, Fort Defiance, AZ 86504-0649 | 2006-10-27 |
| 1225563646 | Loryn Ashlee Wilson | Pediatrics | Corner of Route N12 & N7, Fort Defiance, AZ 86504 | 2017-04-24 |
| 1558733022 | Uykok Ngo | Pharmacist | Corner of Route N12 & N7, Fort Defiance, AZ 86504 | 2015-10-23 |
| 1356637664 | Orena Sam | Registered Nurse | Corner of Route N12 & N7, Fort Defiance, AZ 86504-0649 | 2011-06-24 |
| 1336435783 | Beverly Ann Descheenie | Social Worker | Corner of Route N12 & N7, Fort Defiance, AZ 86504 | 2011-06-23 |
| 1083937569 | Fort Defiance Indian Hospital Board, Incorporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Corner of Route N12 & N7, Fort Defiance, AZ 86504 | 2010-03-11 |
| 1487977914 | The Fort Defiance Indian Hospital Board, Incorporation | Clinic/Center | Corner of Route N12 & N7, Fort Defiance, AZ 86504-0649 | 2010-03-11 |
| 1568694420 | Tracy R. Smith | Audiologist | Corner of Route N12 & N7, Fort Defiance, AZ 86504 | 2009-08-11 |
| 1245487354 | Jason Ryan Price | Dentist | Corner of Route N12 & N7, Fort Defiance Phs Hospital, Fort Defiance, AZ 86504 | 2008-08-20 |
| 1144476870 | Loretta Notah-ashley | Counselor | Corner of Route N12 & N7, Phs Fort Defiance Indian Hospital, Fort Defiance, AZ 86504-0649 | 2008-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807664 | Clifford Charles | Pharmacist | Corners of Route 7&12, Fort Defiance, AZ 86504 | 2020-10-06 |
| 1720605207 | Christopher A Will | Registered Nurse | 2126-1 Shandiin Circle, Fort Defiance, AZ 86504 | 2020-06-30 |
| 1750904207 | Crystal Salaz | Respiratory Therapist, Registered | Corner of Roue N12 and N7, Fort Defiance, AZ 86504 | 2020-05-19 |
| 1003451600 | Rebecca Reeve | Pharmacist | Tsehootsooi Medical Center, Corner of Indian Route 7 and 12, Fort Defiance, AZ 86504 | 2019-11-07 |
| 1851947485 | David Glen Webb | Pharmacist | Hwy 12 Nr 110, Fort Defiance, AZ 86504 | 2019-08-09 |
| 1952963647 | Eukerison Bobby Tsinajinie | Counselor | .25 Miles S Fieldhouse Ra 6905, Fort Defiance, AZ 86504 | 2019-07-02 |
| 1770145567 | Joann Tso I | Counselor | 1/4 Mile Ne of Ft. Defiance Fieldhouse, Ft. Defiance, AZ 86504 | 2019-07-02 |
| 1174185961 | James Leslie | Counselor | 1/4 Mile South of Ft Defiance Fieldhouse Ra#6905, Ft Defiance, AZ 86504 | 2019-07-02 |
| 1184192163 | Miranda Frances Blatchford | Social Worker | .5 Miles Sw of The Fd Field House, Bldg #6905, Fort Defiance, AZ 86504 | 2018-11-07 |
| 1477030914 | Michelle Rosario | Dietitian, Registered | Fort Defiance Indian Hospital Board, Inc., Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-07-27 |
| Find all providers in zip 86504 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679876551 | Fort Defiance Indian Hospital Board, Inc | General Acute Care Hospital | Nw Corner of Navajo Rt. 12 and 7, Fort Defiance, AZ 86504 | 2010-12-14 |
| 1700962131 | Dhhs Phs Naihs Fort Defiance Hospital | General Acute Care Hospital | Corner of Route N12 & N7, Fort Defiance, AZ 86504-0649 | 2006-10-27 |
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| Find all providers with the same taxonomy | ||||
| City | FORT DEFIANCE |
| Zip Code | 86504 |
Please comment or provide details below to improve the information on THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.