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Organization
PUEBLO OF SAN FELIPE
Active
Organization
PUEBLO OF SAN FELIPE
Active
Other names
SAN FELIPE HEALTH CLINIC PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
DARYL CANDELARIA PHARMD RPH (TRIBAL ADMIN)
(505) 867-3381
Entity
Organization
Contact information
Practice address
3 CEDAR ST, SAN FELIPE PUEBLO, SAN FELIPE, NM 87001
(505) 867-5485
(505) 771-9940
Mailing address
PO BOX 4342, PO BOX 4339, SAN FELIPE, NM 87001
(505) 867-9616
(505) 771-9940
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058717
PK
—
05
—
81271875
—
NM
Enumeration date
09/21/2006
Last updated
06/11/2018
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