NPIMap

Organization Active NPI

Maternal Child Health Program

  • Primary Care Clinic/Center
  • San Carlos, AZ
National Provider Identifier
1639519002
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MATERNAL CHILD HEALTH PROGRAM
Practice address
Bulding 15, San Carlos Ave
San Carlos, AZ 85550-9999
Phone
(928) 475-2798
NPI assigned
Jul 1, 2013
Organization subpart
Yes
Parent organization
SAN CARLOS APACHE TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Mr. Terry Rambler
Title
Tribal Chairman
Phone
(928) 475-2361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

Bulding 15, San Carlos Ave
San Carlos, AZ 85550-9999

Mailing address

P.O. Box 0
Building 15, San Carlos Av
San Carlos, AZ 85550-9999
Phone (928) 475-2798

National Provider Directory

National Provider Directory
Tax ID family
San Carlos Apache Tribe7 organizations share this tax ID, including this one
Part of
San Carlos Apache Tribe

Other organizations with this tax ID 6

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": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1639519002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 0",
            "address_2": "BUILDING 15, SAN CARLOS AV",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855509999",
            "telephone_number": "928-475-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BULDING 15, SAN CARLOS AVE",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855509999",
            "telephone_number": "928-475-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL CHILD HEALTH PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN CARLOS APACHE TRIBE",
        "enumeration_date": "2013-07-01",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "RAMBLER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "TRIBAL CHAIRMAN",
        "authorized_official_telephone_number": "928-475-2361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.