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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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