Organization
DHHS PHS NAIHS SHIPROCK HOSPITAL
Active
Other names
Four Corners Regional Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FANNESSA COMER (CEO)
(505) 368-6001
Entity
Organization
Contact information
Practice address
US HWY 160 & NAVAJO ROUTE 35 - RED MESA, TEECNOSPOS, AZ 86514
(928) 656-5000
(505) 656-5164
Mailing address
HCR 61 BOX 30, TEECNOSPOS, AZ 86514
(928) 656-5000
(928) 656-5164
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183669
—
AZ
05
—
282586
—
AZ
05
—
37256718
—
CO
05
—
61109321
—
NM
05
—
7000000084
—
UT
05
—
7000000092
—
UT
Enumeration date
01/26/2007
Last updated
05/09/2013
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