Organization
HASTAADI NEEZNADIIN DBA GALLUP HEALTH
Active
Other names
Gallup Health Cooperative, Gallup Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT DANIEL BURGNER (DIRECTOR)
(505) 726-9642
Entity
Organization
Contact information
Practice address
1108 E HISTORIC HIGHWAY 66, GALLUP, NM 87301-5466
(505) 726-9642
(505) 726-9642
Mailing address
1108 E HISTORIC HIGHWAY 66, GALLUP, NM 87301-5466
(505) 726-9642
(505) 726-9642
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
246RM2200X
Medical Laboratory Technician
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0016486
—
NM
Enumeration date
06/12/2020
Last updated
10/14/2025
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