Organization
HASTAADI NEEZNADIIN DBA GALLUP HEALTH
Active
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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