NPIMap

Organization Active NPI

Tcrhcc Mobile Healthcare Van System

  • Clinic/Center
  • Gap, AZ
National Provider Identifier
1780937482
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TCRHCC MOBILE HEALTHCARE VAN SYSTEM
Practice address
Highway 89 at Mile Post 498
Base of Operations: 167 N. Main St. Tuba City, Az 86045
Gap, AZ 86020
Phone
(928) 283-2501
Fax
(928) 283-2677
NPI assigned
Oct 18, 2012
Last updated
Oct 22, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Joseph T Engelken
Title
Ceo
Phone
(928) 283-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

Highway 89 at Mile Post 498
Base of Operations: 167 N. Main St. Tuba City, Az 86045
Gap, AZ 86020

Mailing address

PO Box 600
Base of Operations: 167 N. Main St. Tuba City, Az 86045
Tuba City, AZ 86045-0600
Phone (928) 283-2781

Other names 1

  • Bodaway/Gap Chapter House-Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Tuba City Regional Health39 organizations share this tax ID, including this one
Part of
Tuba City Regional Health

Other organizations with this tax ID 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1780937482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "address_2": "BASE OF OPERATIONS: 167 N. MAIN ST. TUBA CITY, AZ 86045",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2781",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 89 AT MILE POST 498",
            "address_2": "BASE OF OPERATIONS: 167 N. MAIN ST. TUBA CITY, AZ 86045",
            "city": "GAP",
            "state": "AZ",
            "postal_code": "86020",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TCRHCC MOBILE HEALTHCARE VAN SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUBA CITY REGIONAL HEALTH CARE CORPORATION",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "ENGELKEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-283-2501"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bodaway/Gap Chapter House-Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gap, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.