Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Other names
Salt River DME's
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEANNA J. DICK MSW,. MHA. ((CEO) CHIEF EXECUTIVE OFFICER)
(602) 263-1567
Entity
Organization
Contact information
Practice address
10005 E OSBORN RD, SCOTTSDALE, AZ 85256-4019
(602) 263-1511
(602) 263-1619
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092353
—
AZ
01
—
P0109880
BCBSAZ
AZ
Enumeration date
11/24/2006
Last updated
06/19/2019
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