Organization
DHHS PHS NAIHS SHIPROCK HOSPITAL
Active
Other names
Dzilth Na O Dith Hle Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FANNESSA COMER (CEO)
(505) 368-6001
Entity
Organization
Contact information
Practice address
6 ROAD 7586, BLOOMFIELD, NM 87413-4934
(505) 368-6401
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6401
(505) 368-6431
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
32D0670057
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
UT
Enumeration date
07/14/2009
Last updated
07/14/2009
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