PUEBLO OF ISLETA (NPI# 1407979008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407979008 |
| Entity Type | Organization |
| Organization Name | PUEBLO OF ISLETA |
| Other Organization Name | PUEBLO OF ISLETA PHARMACY |
| Practice Address |
01 Sagebrush St Isleta NM 87022-0000 |
| Practice Telephone | 5058694863 |
| Practice Fax Number | 5058694811 |
| Mailing Telephone | 5058694863 |
| Mailing Fax Number | 5058694811 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2017-05-17 |
| Authorized Official Name | MRS. VOLELLE K ZAMORA (CEO) |
| Authorized Official Telephone | 5058694094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 501C | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00010146 | 05 |
| Other Name | Type Code |
|---|---|
| PUEBLO OF ISLETA PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225158348 | Pueblo of Isleta | Dentist | 01 Sagebrush Rd, Isleta, NM 87022-0000 | 2007-03-30 |
| 1194738328 | Pueblo of Isleta | Clinic/Center | 01 Sagebrush, Isleta, NM 87022 | 2006-08-15 |
| 1326590191 | Pueblo of Isleta | Clinic/Center | 01 Sagebrush, Isleta, NM 87022 | 2016-10-27 |
| 1114040714 | Pueblo of Isleta | Counselor | 01 Sagebrush St, Isleta, NM 87022-0000 | 2007-04-09 |
| 1023191368 | Pueblo of Isleta | Ambulance | 01 Sagebrush, Isleta, NM 87022 | 2006-10-23 |
| Street Address |
01 SAGEBRUSH ST |
| City | ISLETA |
| State | NM |
| Zip Code | 87022-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972699437 | Leslie J Herman | Physical Therapist | 01 Sagebrush St, Isleta, NM 87022-0000 | 2006-10-04 |
| 1225541618 | Natasha Abeita | Registered Nurse | 01 Sagebrush St, Isleta, NM 87022 | 2017-11-08 |
| 1720482235 | Stephanie Ruth Barela | Health Educator | 01 Sagebrush St, Isleta, NM 87022 | 2014-10-13 |
| 1366863706 | Bonnie Evans | Counselor | 01 Sagebrush St, Isleta, NM 87022-0000 | 2014-01-03 |
| 1245417104 | Pueblo of Isleta Behavioral Health | Psychologist | 01 Sagebrush St, Isleta, NM 87022-0000 | 2008-01-23 |
| 1114040714 | Pueblo of Isleta | Counselor | 01 Sagebrush St, Isleta, NM 87022-0000 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669022851 | Roseann Garcia | Technician | Tr 41 House 1, Isleta, NM 87022 | 2019-09-19 |
| 1073027629 | Keely Justice Chavez | Registered Nurse | 01 Sagebrush St., Isleta, NM 87022 | 2017-11-18 |
| 1184048423 | Pueblo of Isleta Assisted Living Facility | Alzheimer Center (Dementia Center) | 1001 Tribal Road 40, Isleta, NM 87022 | 2014-02-06 |
| 1265775597 | Pearlyn Gail Tomosie | Family Medicine | 1 Sagebrush Street, Isleta, NM 87022 | 2013-04-04 |
| 1235471558 | Amber N. Vigil | Dietitian, Registered | 01 Sagebrush Rd., Isleta, NM 87022 | 2013-03-25 |
| 1326219007 | Nancy M Halonen | Registered Nurse | #1 Sagebrush Road, Isleta, NM 87022 | 2008-03-20 |
| 1811197346 | Attlee Becenti Benally | Podiatrist | 1 Sagebrush Rd., Isleta Pueblo Diabetic Clinic, Isleta, NM 87022 | 2007-07-23 |
| 1770708174 | Isleta Elderly Services | Home Health | Tribal Rd. 40 Bldg. 70, Isleta, NM 87022 | 2007-04-13 |
| 1194738328 | Pueblo of Isleta | Clinic/Center | 01 Sagebrush, Isleta, NM 87022 | 2006-08-15 |
| 1831169986 | John James Richter IIi | Dentist | 1 Sagebrush St, Isleta, NM 87022 | 2006-01-23 |
| Find all providers in zip 87022 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629525605 | Canoncito Band of Navajos Health Center, Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Medicine Horse Road, Canoncito, NM 87026 | 2016-09-07 |
| 1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
| 1225155666 | Zia Indian Health Clinic Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 155b Capitol Square Dr, San Ysidro, NM 87053-6013 | 2007-03-22 |
| 1154453413 | Santa Ana Health Clinic Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 02 C Dove Rd, Bernalillo, NM 87004 | 2007-03-12 |
| 1023148608 | Crownpoint Health Care Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Hwy Jct 57 Rt 9, Crownpoint, NM 87313-0358 | 2007-03-06 |
| 1750425484 | Mescalero Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 318 Abalonie Loop, Mescalero, NM 88340 | 2007-02-16 |
| 1073671194 | Pine Hill Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Bia Rt 125, Pine Hill, NM 87357 | 2006-12-04 |
| 1609116573 | Pueblo of Sandia | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2013-02-28 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1124220900 | Jicarilla Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 12000 Stone Lake Rd, Dulce, NM 87528 | 2007-06-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.