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Gila River Health Care Corporation

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Sacaton, AZ

NPI 1891776902 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1891776902
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
GILA RIVER HEALTH CARE CORPORATION
Practice address
565 W. Seed Farm Rd
Sacaton, AZ 85247
Phone
(602) 271-7903
Fax
(602) 271-7970
NPI assigned
Nov 7, 2005
Organization subpart
No

Authorized official

Name
Ms. Jan Anderson
Title
Interim Dialysis Administrator
Phone
(602) 271-7901

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • The Caring House Skilled Nursing Facility · Sacaton, AZ · NPI 1912909391
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · DIRECT OWNERSHIP INTEREST

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 22

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

Practitioners 246

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 246

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1047472Gila River Dialysis East
565 W Seed Farm Rd, Sacaton, AZ 85247		Certificate of waiverNov 6, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Caring House
Sacaton, AZ · CCN 035216		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Direct Ownership Interest (100%)		 Aug 5, 2015
Aug 5, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051026000860 AZ Part a Provider - End-Stage Renal Disease Facility (ESRD) 0648174185 Practice locations: Sacaton, AZ

National Provider Directory

Tax ID family
Gila River Healthcare (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Yes

Addresses

Primary practice location

565 W. Seed Farm Rd
Sacaton, AZ 85247

Mailing address

PO Box 2176
Sacaton, AZ 85247-2176
Phone (602) 271-7903

Other names

  • Gila RIver Dialysis East Doing business as

Other providers in Sacaton, AZ

All providers in Sacaton, AZ · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arizona

Sources for this page

Verify at the official NPI Registry.