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Organization

WHITE MOUNTAIN APACHE

Active
Parent organization
WHITE MOUNTAIN APACHE TRIBE
Organization subpart
Yes

Provider details

NPI number
Legal business name
WHITE MOUNTAIN APACHE TRIBE
Authorized official
EMMIE CROMWELL (DIRECTOR)
(928) 338-1808
Entity
Organization

Contact information

Practice address
522 SOUTH FOURTH AVENUE, WHITERIVER, AZ 85941
(928) 338-1808
(928) 338-5254
Mailing address
PO BOX 1210, WHITERIVER, AZ 85941-1210
(928) 338-1808
(928) 338-5252

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044701
AZ
Enumeration date
03/17/2008
Last updated
03/17/2008
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