DHHS PHS Naihs Shiprock Hospital
Organization Active NPI Clinical Medical Laboratory · Bloomfield, NM
NPI 1083843841 · NPPES record last updated Jul 14, 2009
Key facts
- NPI
- 1083843841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 32D0670057
- Legal business name
- DHHS PHS NAIHS SHIPROCK HOSPITAL
- Practice address
- 6 Road 7586
Bloomfield, NM 87413-4934 - Phone
- (505) 368-6401
- Fax
- (505) 368-6431
- NPI assigned
- Jul 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Fannessa Comer
- Title
- Ceo
- Phone
- (505) 368-6001
Corporate family (same tax ID) 14
Practitioners 1
-
Susie A John, MD MPH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D0670057 | Dzilth NA O Dith Hle Health Center | Accreditation | Aug 6, 2027 |
National Provider Directory
- Tax ID family
- DHHS PHS Naihs Shiprock H
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 32D0670057 | Yes |
Addresses
Primary practice location
6 Road 7586
Bloomfield, NM 87413-4934
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | UT |
Other names
- Dzilth Na O Dith Hle Health Center
Other providers in Bloomfield, NM
- Anna Marie Curtis
- Kellen Dean
- Karen Dennis
- Nicole Marie Desouchet
- Deanna Devore
- DHHS PHS Naihs Shiprock Hospital
- DHHS PHS Naihs Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
- Victoria Dominguez
All providers in Bloomfield, NM · Clinical Medical Laboratory in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.