NPIMap

Organization Active NPI

The Fort Defiance Indian Hospital Board, Incorporation

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Fort Defiance, AZ
National Provider Identifier
1083937569
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION
Practice address
Corner of Route N12 & N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
Fax
(928) 729-8169
NPI assigned
Mar 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sandra L.S. Adkins, DDS
Title
Chief Executive Officer
Phone
(928) 729-8902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

Corner of Route N12 & N7
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

Other identifiers 1

IdentifierTypeStateIssuer
0356609OtherNCPDP NUMBER

Other names 1

  • Fort Defiance Indian Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fort Defiance Indian Hospital Board Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1083937569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 & N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L.S.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-729-8902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "0356609",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Defiance Indian Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Defiance Indian Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.