NPIMap

Organization Active NPI

Salt River Pima-Maricopa Indian Community

Doing business as Salt River Integrated Health Care - Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Scottsdale, AZ
National Provider Identifier
1790210755
Registry record updated Mar 2, 2022
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
SALT RIVER PIMA-MARICOPA INDIAN COMMUNITY
Doing business as
Salt River Integrated Health Care - Pharmacy
Practice address
10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019
Phone
(480) 946-9227
Fax
(480) 278-7186
NPI assigned
Apr 27, 2017
Last updated
Mar 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Violet Mitchell-Enos
Title
Director
Phone
(480) 362-5480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019

Mailing address

10005 E Osborn Rd BLDG 61
Scottsdale, AZ 85256-4019
Phone (480) 946-9227

Other identifiers 2

IdentifierTypeStateIssuer
2171598OtherPK
275266MedicaidAZ

Other names 2

  • Salt River Integrated Health Care - Pharmacy Doing business as
  • Salt River Integrated Health Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180108001704 TX Part B Supplier - Pharmacy 6204078025 Practice locations: Scottsdale, AZ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Salt River Pima-Maricopa Indian6 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.

Locations

10005 E Osborn Rd
Bldg 61
Scottsdale, AZ 85256
Phone (480) 946-9066

Practitioners & affiliated clinicians

Practitioners 4

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": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1790210755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10005 E OSBORN RD BLDG 61",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852564019",
            "telephone_number": "480-946-9227",
            "fax_number": "480-278-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005 E OSBORN RD BLDG 61",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852564019",
            "telephone_number": "480-946-9227",
            "fax_number": "480-278-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT RIVER PIMA-MARICOPA INDIAN COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "MITCHELL-ENOS",
        "authorized_official_first_name": "VIOLET",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-362-5480"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "PK",
            "identifier": "2171598",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275266",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt River Integrated Health Care - Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Salt River Integrated Health Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.