DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER (NPI# 1548597743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548597743 |
| Entity Type | Organization |
| Organization Name | DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER |
| Practice Address |
12000 Stone Lake Road Jicarilla Service Unit Dulce NM 87528 |
| Mailing Address |
P O Box 187 12000 Stone Lake Road Dulce NM 87528-0187 |
| Practice Telephone | 5757593291 |
| Practice Fax Number | 5757593532 |
| Mailing Telephone | 5757593291 |
| Mailing Fax Number | 5757593532 |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |
| Authorized Official Name | CHARLENE HAMILTON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5757597200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
18451 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000K3526 | 05 | |
| NM | MEDICARE PART B | HSZ196 | 01 |
| Street Address |
12000 STONE LAKE ROAD JICARILLA SERVICE UNIT |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568453702 | Richard Allen March | Physician Assistant | 12000 Stone Lake Road, Dulce, NM 97528-3291 | 2005-11-04 |
| 1770809527 | Ursula Michael Gabriel | Nurse's Aide | 12000 Stone Lake Road, Dulce, NM 87528 | 2010-04-19 |
| 1467778365 | Cynthia M. Montanez | Registered Nurse | 12000 Stone Lake Road, Jicarilla Service Unit, Dulce, NM 87528 | 2010-04-16 |
| 1184946626 | Inna Voinich | Pharmacist | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2010-02-25 |
| 1619117116 | Darlene Peshlakai Valdez | Nurse's Aide | 12000 Stone Lake Road, Dulce, NM 87528 | 2009-02-24 |
| 1487805198 | Anna V. Hall | Spec/Tech, Pathology | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2008-10-01 |
| 1629228507 | Marcia Ann Sahmaunt | Technician, Pathology | 12000 Stone Lake Road, Dulce, NM 87528 | 2008-09-26 |
| 1851550776 | Diana Connell | Registered Nurse | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2008-06-05 |
| 1043479330 | E Joan Wilson | Specialist/Technologist, Other | 12000 Stone Lake Road, Dulce, NM 87528 | 2008-06-03 |
| 1760554695 | Ann Marie Toledo | Dental Hygienist | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2006-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
| 1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
| 1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
| 1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
| 1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
| 1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
| Find all providers in zip 87528 | ||||
| Taxonomy Code | 261QP0904X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Public Health, Federal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750388963 | Dulce Health Center | Clinic/Center | 500 North Mundo, Dulce, NM 87528-0187 | 2005-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538344965 | Marvin Denzel Call | Clinic/Center | 2178 Cattail Willow Ave Ne, Albuquerque, NM 87122-1023 | 2008-01-03 |
| 1477676567 | Pueblo of Jemez | Clinic/Center | 110 Sheepsprings Way, Jemez Pueblo, NM 87024 | 2007-04-06 |
| 1013011212 | Alamo Navajo Health Center | Clinic/Center | 30 Miles N of Hwy 60 On Hwy 169, Magdalena, NM 87825-0907 | 2006-09-11 |
| 1952771750 | Santa Fe Indian Hospital | Clinic/Center | 1700 Cerrillos Rd, Santa Fe, NM 87505-3026 | 2015-10-06 |
| 1932221231 | Albuquerque Indian Health Center Pharmacy | Clinic/Center | 801 Vassar Dr Ne, Pharmacy Department, Albuquerque, NM 87106-2725 | 2007-04-06 |
| 1225150535 | Sandia Phs Health Center | Clinic/Center | 481 Sandia Loop, Bernalillo, NM 87004-7076 | 2007-04-06 |
| 1679614598 | Indian Health Service | Clinic/Center | 481 Sandia Loop, Pueblo of Sandia, Bernalillo, NM 87004-7076 | 2007-02-12 |
| 1902875594 | Dhhs, Phs, Naihs, Gallup Indian Medical Center | Clinic/Center | 007 Choosgai Drive, Tohatchi, NM 87325 | 2006-03-16 |
| 1851377667 | Indian Health Service | Clinic/Center | 801 Vassar Dr Ne, Albuquerque, NM 87106-2725 | 2005-12-22 |
Please comment or provide details below to improve the information on DHHS/IHS/AAO/JSU/DULCE HEALTH CENTER.
| 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.