Organization
PUEBLO OF SAN FELIPE
Active
Other names
San Felipe Pueblo health & Wellness Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE D. GARCIA (PUEBLO OF SAN FELIPE TRIBAL ADMIN)
(505) 867-3381
Entity
Organization
Contact information
Practice address
3 CEDAR RD., SAN FELIPE, NM 87001
(505) 867-9616
(505) 771-9992
Mailing address
PO BOX 4339, SAN FELIPE, NM 87001
(505) 867-9616
(505) 771-9992
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81271875
PHARMACY
NM
05
—
81271875
—
NM
05
—
99624371
—
NM
Enumeration date
11/02/2006
Last updated
07/15/2009
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