# PHOENIX INDIAN MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INDIAN PUBLIC HEALTH SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144382219
- **Authorized official:** MS. VELLIYAH ELLEN CRAIG RPH (PHARMACIST)
- **Authorized official phone:** (602) 263-1200

## Contact information

- **Practice address:** 4212 N 16TH ST, PHOENIX, AZ 85016-5319
- **Practice address phone:** (602) 296-4750
- **Practice address fax:** (602) 263-1621
- **Mailing address:** 6414 S 26TH AVE, PHOENIX, AZ 85041-5365
- **Mailing address phone:** (602) 296-4750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | RP00005927 | NM | Yes |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 08/22/2020