PUEBLO OF SAN FELIPE (NPI# 1265511299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265511299 |
Entity Type | Organization |
Organization Name | PUEBLO OF SAN FELIPE |
Other Organization Name | SAN FELIPE PUEBLO HEALTH & WELLNESS DEPARTMENT |
Practice Address |
3 Cedar Rd. San Felipe NM 87001 |
Mailing Address |
Po Box 4339 San Felipe NM 87001 |
Practice Telephone | 5058679616 |
Practice Fax Number | 5057719992 |
Mailing Telephone | 5058679616 |
Mailing Fax Number | 5057719992 |
Enumeration Date | 2006-11-02 |
Last Update Date | 2009-07-15 |
Authorized Official Name | MR. BRUCE D. GARCIA (PUEBLO OF SAN FELIPE TRIBAL ADMIN) |
Authorized Official Telephone | 5058673381 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 99624371 | 05 | |
NM | PHARMACY | 81271875 | 01 |
NM | 81271875 | 05 |
Other Name | Type Code |
---|---|
San Felipe Pueblo health & Wellness Department | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467550475 | Pueblo of San Felipe | Pharmacy | 3 Cedar St, San Felipe Pueblo, San Felipe, NM 87001 | 2006-09-21 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | PUEBLO OF SAN FELIPE | 127 Hagon Rd, San Felipe Pb, NM 87001-8087 |
Street Address |
3 CEDAR RD. |
City | SAN FELIPE |
State | NM |
Zip Code | 87001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740751841 | Edward Gary Gum | Registered Nurse | #3 Cedar Road, San Felipe Pueblo, NM 87001 | 2018-12-16 |
1194229278 | Michael Townsend | Peer Specialist | 3 Cedar Rd, Algodones, NM 87001 | 2018-03-22 |
1750837332 | Kaitlyn Therese Archibeque | Specialist/Technologist | 1370a Hwy 313, Algodones, NM 87001 | 2016-09-01 |
1992154850 | Tonya Louis | Social Worker | 25 Cougar Road, San Felipe, NM 87001 | 2016-06-10 |
1821391806 | Gail Aguilar | Counselor | 18 Cougar Road, San Felipe Behavioral Health Program, San Felipe, NM 87001 | 2010-12-13 |
1740341304 | David M Hanson | Dentist | #4 Cedar Street, San Felipe, NM 87001 | 2006-12-13 |
1831274851 | San Felipe Health Clinic | General Acute Care Hospital | Cedar Street, San Felipe, NM 87001 | 2006-10-26 |
1164439261 | Marvin Jordan Godner | Pediatrics | 711 Pueblo Main Street, San Felipe Pueblo, NM 87001 | 2006-08-02 |
1366425712 | Julie Anna King | Pharmacist | San Felipe Health Clinic Pharmacy, Cedar Street #4 San Felipe Pueblo, San Felipe, NM 87001 | 2005-11-21 |
1790247583 | Timothy Earle Moeslein | Registered Nurse | #3 Cedar Road, San Felipe Pueblo, NM 87001 | 2019-04-02 |
Find all providers in zip 87001 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1700345436 | Lancer Health Group, LLC | Clinic/Center | 1400 S 2nd St, Raton, NM 87740-2102 | 2019-03-12 |
1265998314 | Stillwater Therapeutic Bodywork | Clinic/Center | 460 Saint Michaels Dr Ste 1205, Santa Fe, NM 87505-8605 | 2019-02-13 |
1891281259 | Pain and Addiction Services, LLC | Clinic/Center | 1110 Pennsylvania St Ne Ste B, Albuquerque, NM 87110-7404 | 2018-07-09 |
1477076008 | Florecer Therapies Inc | Clinic/Center | 1320 Arenal Rd Sw, Albuquerque, NM 87105-4030 | 2017-07-25 |
1750767810 | Southwest Care Center Jefferson Albuquerque | Clinic/Center | 4710 Jefferson Ne, Suite A, Albuquerque, NM 87109 | 2015-07-30 |
1366782526 | Premise Health of New Mexico Medical P C | Clinic/Center | 6401 Jefferson St Ne, Albuquerque, NM 87109-4376 | 2013-02-26 |
1063788701 | Integrated Wellness | Clinic/Center | 10209 Nacimiento St Nw, Albuquerque, NM 87114-4457 | 2012-03-27 |
1336442854 | San Cristobal Treatment Center | Clinic/Center | 176 Camino Del Medio, San Cristobal, NM 87564 | 2010-12-07 |
Find all providers with the same taxonomy |
City | SAN FELIPE |
Zip Code | 87001 |
Please comment or provide details below to improve the information on PUEBLO OF SAN FELIPE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.