PUEBLO OF SANDIA (NPI# 1609116573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609116573 |
| Entity Type | Organization |
| Organization Name | PUEBLO OF SANDIA |
| Other Organization Name | SANDIA PHARMACY |
| Practice Address |
203 Sandia Day School Road Bernalillo NM 87004-7076 |
| Mailing Address |
481 Sandia Loop Bernalillo NM 87004-7076 |
| Practice Telephone | 5058674696 |
| Practice Fax Number | 5058674997 |
| Mailing Telephone | 5058674696 |
| Mailing Fax Number | 5058674997 |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2015-10-01 |
| Authorized Official Name | MS. CARRIE SARNICKY (DIRECTOR, HEALTH AND SOCIAL SERVICE) |
| Authorized Official Telephone | 5058674696 |
| Authorized Official Credential | MBA |
| 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 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00010462 | 05 | |
| PTAN | TRZ029 | 01 |
| Other Name | Type Code |
|---|---|
| Sandia Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548588643 | Pueblo of Sandia | Clinic/Center | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2010-05-13 |
| Street Address |
203 SANDIA DAY SCHOOL ROAD |
| City | BERNALILLO |
| State | NM |
| Zip Code | 87004-7076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790784973 | Dianna Lynne Fury | Family Medicine | 203 Sandia Day School Road, Bernalillo, NM 87004 | 2005-07-19 |
| 1922351238 | Robin Lovato | Physical Therapist | 203 Sandia Day School Road, Bernalillo, NM 87004 | 2012-10-24 |
| 1730439787 | Patricia Carpio | Counselor | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2012-09-18 |
| 1548588643 | Pueblo of Sandia | Clinic/Center | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2010-05-13 |
| 1356497879 | Cathleen Durell | Family Medicine | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912557729 | Mary Webster Birch | Technician | 306 Riesling Rd, Bernalillo, NM 87004 | 2019-09-13 |
| 1992364483 | Vineeta Kannan | Pharmacist | 203 Sandia Day School Rd., Bernalillo, NM 87004 | 2019-06-10 |
| 1003339748 | Bryanna M Vaio | Pharmacist | 460 Nm Hwy 528, Bernalillo, NM 87004 | 2017-07-25 |
| 1033668843 | Charlotte Branson | Registered Nurse | 301 Calle De Escuela, Bernalillo, NM 87004 | 2016-09-22 |
| 1740737394 | Karin Ludi | Registered Nurse | 148 Spartan Alley, Bernalillo, NM 87004 | 2016-09-01 |
| 1356729214 | Mirey Hernandez | Case Manager/Care Coordinator | 255a Carino Del Pueblo, Bernalillo, NM 87004 | 2015-05-12 |
| 1396138038 | Enchanted Hills Dentistry, Professional Corporation | Dentist | 470 New Mexico 528, A, Bernalillo, NM 87004 | 2015-03-05 |
| 1912319609 | Tate Rubinstein | Acupuncturist | 438 S. Camino Del Pueblo, Bernalillo, NM 87004 | 2014-05-29 |
| 1083043400 | Maria De Lourdes M. Grafe | Case Manager/Care Coordinator | 255-a Camino Del Pueblo, Bernalillo, NM 87004 | 2013-11-06 |
| 1932548799 | Bryan Graziano | Dentist | 470 Pat D'arco Hwy, Unit A, Bernalillo, NM 87004 | 2013-06-14 |
| Find all providers in zip 87004 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 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 |
| 1407979008 | Pueblo of Isleta | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 01 Sagebrush St, Isleta, NM 87022-0000 | 2007-04-09 |
| 1104943950 | Zuni Indian Hospital Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Route 301 North B St, Zuni, NM 87327 | 2007-03-26 |
| Find all providers with the same taxonomy | ||||
| City | BERNALILLO |
| Zip Code | 87004 |
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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.