PUEBLO OF SAN FELIPE NPI 1265511299

NPI Information

NPI: 1265511299
Provider Name: PUEBLO OF SAN FELIPE

Other Name: SAN FELIPE PUEBLO HEALTH & WELLNESS DEPARTMENT

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 32D2064748

Address:
3 CEDAR RD.
SAN FELIPE, NM
ZIP 87001
Phone: (505) 867-9616
Get Directions

PUEBLO OF SAN FELIPE is a multi-specialty clinic center in San Felipe, NM. PUEBLO OF SAN FELIPE NPI is 1265511299. The provider is registered as an organization entity type.
The provider Other Name Is San Felipe Pueblo Health & Wellness Department.

The provider's business location address is:

3 CEDAR RD.
SAN FELIPE, NM
ZIP 87001
Phone: (505) 867-9616
Fax: (505) 771-9992

The provider's authorized official is Bruce D. Garcia .
The authorized official title is Pueblo Of San Felipe Tribal Admin and has the following contact phone number (505) 867-3381.

The CLIA number assigned to this NPI record is 32D2064748 - health main. organization with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 7/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	81271875	OTHER	NEW MEXICO	PHARMACY
2	81271875	MEDICAID	NEW MEXICO
3	99624371	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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