# DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Phoenix Indian Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083643738
- **Authorized official:** MISS LAURA A TILLMAN MD (CMO)
- **Authorized official phone:** (602) 581-6080

## Contact information

- **Practice address:** 4212 N 16TH ST, PHOENIX, AZ 85016-5319
- **Practice address phone:** (602) 263-1200
- **Practice address fax:** (602) 200-5383
- **Mailing address:** PO BOX 95460, CLEVELAND, OH 44101-0033
- **Mailing address phone:** (602) 581-6088
- **Mailing address fax:** (602) 263-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 03/19/2024