NPIMap

Organization Active NPI

Gila River Health Care Corporation DME

Doing business as DME Division

  • Durable Medical Equipment & Medical Supplies
  • Sacaton, AZ
National Provider Identifier
1104980911
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
07-488076N Issued in AZ
Legal business name
GILA RIVER HEALTH CARE CORPORATION DME
Doing business as
DME Division
Practice address
483 West Seed Farm Rd
Gila River Health Care Corporation
Sacaton, AZ 85247-0038
Phone
(888) 484-8526
Fax
(602) 528-1245
NPI assigned
Dec 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Loren P. Ellory
Title
C.E.O.
Phone
(602) 528-1431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 07-488076N AZ Primary

Addresses

Primary practice location

483 West Seed Farm Rd
Gila River Health Care Corporation
Sacaton, AZ 85247-0038

Mailing address

483 W. Seed Farm Road
P. O. Box 38
Sacaton, AZ 85247
Phone (888) 484-8526

Other names 1

  • DME Division Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Huhukam Memorial Hospit23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104980911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM ROAD",
            "address_2": "P. O. BOX 38",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85247",
            "telephone_number": "888-484-8526",
            "fax_number": "602-528-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 WEST SEED FARM RD",
            "address_2": "GILA RIVER HEALTH CARE CORPORATION",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "852470038",
            "telephone_number": "888-484-8526",
            "fax_number": "602-528-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILA RIVER HEALTH CARE CORPORATION DME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLORY",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "602-528-1431"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "07-488076N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DME Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacaton, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.