Organization
KEWA PUEBLO HEALTH CORPORATION
Active
Parent organization
KEWA PUEBLO HEALTH CORPORATION
Other names
Santo Domingo Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEWA PUEBLO HEALTH CORPORATION
Authorized official
VANESSA D VIGIL (BUSINESS OFFICE MANAGER)
(505) 465-3069
Entity
Organization
Contact information
Practice address
85 W HIGHWAY 22, SANTO DOMINGO, NM 87052
(505) 465-3060
(505) 465-1191
Mailing address
P.O. BOX 559, SANTO DOMINGO, NM 87052
(505) 465-3060
(505) 465-1191
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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