CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC (NPI# 1629525605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629525605 |
| Entity Type | Organization |
| Organization Name | CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC |
| Other Organization Name | CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC |
| Practice Address |
129 Medicine Horse Road Canoncito NM 87026 |
| Mailing Address |
129 Medicine Horse Rd Canoncito NM 87026 |
| Practice Telephone | 5059082307 |
| Practice Fax Number | 5059082310 |
| Mailing Telephone | 5059082307 |
| Mailing Fax Number | 5059082310 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2017-02-21 |
| Authorized Official Name | ALEXANDER VARGA (LCDR/ CHIEF PHARMACIST) |
| Authorized Official Telephone | 5059082307 |
| 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 | 1962591669 | 05 | |
| NM | 1124119698 | 05 | |
| NM | 1295726073 | 05 | |
| TX | 1619061090 | 05 | |
| PK | 2166309 | 01 | |
| NM | 1205092160 | 05 |
| Other Name | Type Code |
|---|---|
| Canoncito Band of Navajos Health Center, Inc | Doing Business As Name - Organization |
| Street Address |
129 MEDICINE HORSE ROAD |
| City | CANONCITO |
| State | NM |
| Zip Code | 87026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841833589 | Davina M Segay | Prevention Professional | 7 Rio San Jose St, Laguna, NM 87026 | 2019-10-25 |
| 1467094029 | Donovan Lucero | Peer Specialist | 7 Rio San Jose Dr, Laguna, NM 87026 | 2019-10-15 |
| 1316589534 | Kenneth Thomas | Counselor | 7 Rio San Jose, Laguna, NM 87026 | 2019-10-09 |
| 1528586435 | Romilly Ortiz | Physician Assistant | 129 Medicine Horse Dr, Canoncito, NM 87026 | 2017-08-31 |
| 1174071534 | Laguna Early Childhood Program | Early Intervention Provider Agency | I40 W 114 Bldg 1125, Laguna, NM 87026 | 2016-09-14 |
| 1144535337 | Lisa Marie King | Counselor | 86 Medicine Horse Dr., 86 Medicine Horse Dr., Canoncito, NM 87026 | 2010-08-11 |
| 1619151651 | Rosi Aragon | Counselor | Tbhs Building, I-40, 26 Mi. W. of Abq, Exit 131, 3 Mi. N., To'hajiilee, NM 87026 | 2007-12-27 |
| 1538343579 | Canoncito Band of Navajo Health Center, Inc | Community/Behavioral Health | 96 Medicine Horse Dr., To'hajiilee, NM 87026 | 2007-12-27 |
| 1992999296 | Ruth Lynne Kelly | Social Worker | I40 W Exit 131 Highway 56 N, Acl Teen Centers To'hajiilee Community School, To'hajiilee, NM 87026 | 2007-08-29 |
| 1194941823 | Mary Frances Sarracino | Social Worker | Exit 114, Us Route 66, Laguna, NM 87026 | 2007-04-18 |
| Find all providers in zip 87026 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 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.