DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM; NPI #1508887993

Contact Information

DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM

6932 EAST 1400 SOUTH
FORT DUCHESNE, UT 84026

Phone: 435-722-5122
Fax: 435-722-9137
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Public Health, Federal	261QP0904X

Indicates primary specialty

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

NPI Number 1508887993

LBN Legal business name DHEW IND HLTH SV HLTH SVS&MNTAL HLTH ADM

Authorized official MAURICE JAMES - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/21/2006

Last updated 02/23/2026 - About 3 months ago

Identifiers

UT	Medicaid	700000000009
AZ	Other	AZ0522260	BLUE CROSS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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