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Organization
PUEBLO OF SANDIA
Active
Organization
PUEBLO OF SANDIA
Active
Other names
Sandia Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN WASETA (BUSINESS OFFICE MANAGER)
(505) 771-5174
Entity
Organization
Contact information
Practice address
203 SANDIA DAY SCHOOL ROAD, BERNALILLO, NM 87004-7076
(505) 867-4696
(505) 771-5107
Mailing address
481 SANDIA LOOP, BERNALILLO, NM 87004-7076
(505) 867-4696
(505) 867-4997
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35922079
—
NM
Enumeration date
05/13/2010
Last updated
05/22/2025
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