Organization
SOUTHERN UTE INDIAN TRIBE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE VELASCO (HEALTH CENTER DIRECTOR)
(970) 563-4742
Entity
Organization
Contact information
Practice address
123 WEEMINUCHE, IGNACIO, CO 81137
(970) 563-4781
(970) 563-0207
Mailing address
PHARMACY DEPT, PO BOX 899, IGNACIO, CO 81137
(970) 563-4581
(970) 563-0206
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003394
PK
—
05
—
67553541
—
CO
Enumeration date
03/23/2007
Last updated
08/04/2022
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