Phoenix Indian Medical Center

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

RP00005927 Issued in NM

Legal business name

PHOENIX INDIAN MEDICAL CENTER

Practice address

4212 N 16TH St
Phoenix, AZ 85016-5319

Phone

(602) 296-4750

Fax

(602) 263-1621

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Velliyah Ellen Craig, RPHNPI 1639218019

Title

Pharmacist

Phone

(602) 263-1200

Specialties & licenses 1

Addresses

Other names 1

• INDIAN PUBLIC HEALTH SERVICES Other name

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.

• Velliyah Ellen Craig, RPH

  • Pharmacist
  • Phoenix, AZ
  • NPI 1639218019
  NPD (past) Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144382219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6414 S 26TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415365",
            "telephone_number": "602-296-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-296-4750",
            "fax_number": "602-263-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX INDIAN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "VELLIYAH",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "602-263-1200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NM",
            "license": "RP00005927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INDIAN PUBLIC HEALTH SERVICES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Phoenix Heart Hospice LLC
• Phoenix Home Health Nursing Services, Inc.
• Phoenix Home Health Services LLC
• Phoenix Id LLC
• Phoenix Indian Center, Inc.
• Phoenix Indian Medical Center
• Phoenix Infectious Diseases Consultants LLC
• Phoenix Infectious Diseases Consultants, LLC
• Phoenix Infinity Group LLC (Flower of Life Hospice Care)
• Phoenix Institute of Cardiology

• Public Health or Welfare Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Public Health or Welfare Agency in Arizona

• 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.