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FQHC638024 UNITED INDIAN HEALTH SERVICES (Active)
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Main Details
Name
UNITED INDIAN HEALTH SERVICES
Subdivision Name
POTAWAT CLINIC
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638024
Additional Details
Current Program Status
Active
Registration Date
1/1/1995
Participating Start Date
1/1/1995
Participating Approval Date
11/18/2008
Last Recertification Date
3/3/2025
Contacts
Authorizing Official
United Indian Health Services
Christopher Myers, Chief Clinical Officer
(707) 825-4070
Primary Contact
United Indian Health Services
Kanako Miyamoto, Pharmacy Director
(707) 825-4095
Addresses
Street Address
1600 WEEOT WAY
ARCATA, CA 95521
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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11/19/08 ADDED MEDICAID #
01/01/1995
April 2025
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