NPIMap

Organization Active NPI

Utah Navajo Health System, Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Blanding, UT
National Provider Identifier
1992292544
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
UTAH NAVAJO HEALTH SYSTEM, INCORPORATED
Doing business as
San Juan River Medical
Practice address
799 S 200 W
Blanding, UT 84511-3909
Phone
(435) 678-0733
NPI assigned
Apr 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mr. Garrett Holly
Title
Business Office Director
Phone
(435) 651-3718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

799 S 200 W
Blanding, UT 84511-3909

Mailing address

PO Box 130
Montezuma Creek, UT 84534-0130
Phone (435) 651-3718

Other identifiers 1

IdentifierTypeStateIssuer
1811991151MedicaidUT

Other names 1

  • San Juan River Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blanding Family Practices15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1992292544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-651-3718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 S 200 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113909",
            "telephone_number": "435-678-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH NAVAJO HEALTH SYSTEM, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "HOLLY",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "435-651-3718",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811991151",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan River Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Juan River Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blanding, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.