National Provider Identifier Database

DHEW IND HLTH SV HLTH SVSMNTAL HLTH ADM
Public Health, Federal


Contact Information

DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM
6932 EAST 1400 SOUTH
FORT DUCHESNE, UT84026
Phone: 435-722-5122
Fax: 435-722-9137
Website:
Specialty Taxonomy Code
* Public Health, Federal 261QP0904X

* Indicates primary specialty

NPI Profile & details for DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM

NPI Number 1508887993
Legal business name
LBN
DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM
Authorized official MAURICE JAMES - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 07/21/2006
Last updated 02/23/2026 - About 3 months ago
Sole proprietor1 Not specified
Identifiers
  • UT Medicaid: 700000000009
  • AZ Other: AZ0522260 BLUE CROSS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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