PHS FORT DEFIANCE INDIAN HOSPITAL – NPI #1790953214
Clinic/Center

PHS FORT DEFIANCE INDIAN HOSPITAL is an AHC clinic located in FORT DEFIANCE, AZ. NPPES has assigned the NPI number 1790953214 to PHS FORT DEFIANCE INDIAN HOSPITAL on February 19, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PHS FORT DEFIANCE INDIAN HOSPITAL” is a dba name, the actual legal business name for this organization is DHHS PHS NAIHS FORT DEFIANCE HOSPITAL. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 18 years ago on May 27, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PHS FORT DEFIANCE INDIAN HOSPITAL below.

NPI Profile for
DHHS PHS NAIHS FORT DEFIANCE HOSPITAL

NPI Number
1790953214
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DHHS PHS NAIHS FORT DEFIANCE HOSPITAL
Doing Business As (dba): PHS FORT DEFIANCE INDIAN HOSPITAL
Primary location
CORNER OF ROUTE N12 & N7
FORT DEFIANCE, AZ 86504
Phone: (928) 729-8003 Fax: (928) 729-8158
Mailing address
PO BOX 649
CORNER OF ROUTE N12 & N7
FORT DEFIANCE, AZ 86504-0649
Phone: (928) 729-8014 Fax: (928) 729-8158
Organization Subpart
No
Authorized Official
FRANKLIN FREELAND
CEO
Phone: (928) 729-8014
Updated
Identifiers

Identifiers for PHS FORT DEFIANCE INDIAN HOSPITAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDAZ417982
MEDICAIDNMH0010
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 AZ 282N00000X

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.