Organization
DHEW IND HLTH SV HLTH SVS & MNTAL HLTH ADM
Active
Organization
DHEW IND HLTH SV HLTH SVS & MNTAL HLTH ADM
Active
Other names
FT. DUCHESNE INDIAN HEALTH CENTER DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DELBERT GARY MARTIN RPH (CHIEF PHARMACIST)
(435) 725-6874
Entity
Organization
Contact information
Practice address
6822 EAST 1000 SOUTH, FT DUCHESNE INDIAN HEALTH CENTER DME, FORT DUCHESNE, UT 84026
(435) 722-5122
(435) 722-9137
Mailing address
6822 EAST 1000 SOUTH, FT DUCHESNE INDIAN HEALTH CENTER DME, FORT DUCHESNE, UT 84026
(435) 722-5122
(435) 722-9137
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
700000000009
—
UT
Enumeration date
01/10/2007
Last updated
04/04/2013
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