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Contact Information

FORT MOJAVE INDIAN TRIBE
1607 PLANTATION RD
MOHAVE VALLEY, AZ86440-9686
 Phone: 928-346-4679
 Fax: 928-346-4686
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for FORT MOJAVE INDIAN TRIBE

NPI Number 1306897962
LBN Legal business name FORT MOJAVE INDIAN TRIBE
Authorized official TIM WILLIAMS - (TRIBAL CHAIRPERSON)
Entity Organization
Organization subpart 1 No
Enumeration date 05/16/2006
Last updated 02/06/2023 - About 3 years ago
Identifiers
AZ Medicaid 890211
Other 0500888779 CLIA
CA Other EAP00010F EAPC
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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