KEWA PUEBLO HEALTH CORPORATION (NPI# 1679842983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679842983 |
| Entity Type | Organization |
| Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Other Organization Name | SANTO DOMINGO HEALTH CENTER |
| Practice Address |
85 W Highway 22 Santo Domingo NM 87052 |
| Mailing Address |
P.o. Box 559 Santo Domingo NM 87052 |
| Practice Telephone | 5054653060 |
| Practice Fax Number | 5054651191 |
| Mailing Telephone | 5054653060 |
| Mailing Fax Number | 5054651191 |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |
| Authorized Official Name | VANESSA D VIGIL (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 5054653069 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| Other Name | Type Code |
|---|---|
| Santo Domingo Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467739888 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo Pueblo, NM 87052-0559 | 2011-11-14 |
| 1336659077 | Kewa Pueblo Health Corporation | Community/Behavioral Health | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2017-10-09 |
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1811274061 | Kewa Pueblo Health Corporation | Clinical Medical Laboratory | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 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 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| Street Address |
85 W HIGHWAY 22 |
| City | SANTO DOMINGO |
| State | NM |
| Zip Code | 87052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1811274061 | Kewa Pueblo Health Corporation | Clinical Medical Laboratory | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 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 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353972 | Karin Luzzi | Registered Nurse | 100 Highway 22 W, Santo Domingo, NM 87052 | 2016-09-07 |
| 1043676273 | Kyle Maestas | Physician Assistant | 85 West Hwy 22, Santo Domingo, NM 87052 | 2016-01-04 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1720335219 | Samantha Nicole Torres | Pharmacist | 85 W Hwy 22, Santo Domingo, NM 87052 | 2012-08-14 |
| 1780835504 | Roger L Leonard | Clinic/Center | #85 West Hwy 22, Santo Domingo, NM 87052 | 2008-10-10 |
| 1679766489 | Santo Domingo Tribe | Ambulance | #1 Tesuque St., Ems Headquarters, Santo Domingo Pueblo, NM 87052 | 2007-08-24 |
| 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 |
| 1467509612 | Andrea Heeter | Specialist/Technologist | Santo Domingo Health Center, 85 Hwy 22, Santo Domingo, NM 87052 | 2007-01-03 |
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1053920520 | John Patirck Pagett | Registered Nurse | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2020-07-30 |
| Find all providers in zip 87052 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690423 | David A. Bustos | Non-emergency Medical Transport (VAN) | 1736 Calle Culebra, Espanola, NM 87532 | 2020-08-24 |
| 1003427410 | Mountain Chariot LLC | Non-emergency Medical Transport (VAN) | 8206 Louisiana Blvd Ne Ste A310, Albuquerque, NM 87113-1738 | 2020-08-11 |
| 1952925943 | Zstar LLC | Non-emergency Medical Transport (VAN) | 2640 Sunset Pl, Las Cruces, NM 88011-0843 | 2020-06-04 |
| 1891329736 | New Mexico Non-emergency Medical Transport Incorporated | Non-emergency Medical Transport (VAN) | 503 Hermosa Cir, Las Vegas, NM 87701-9742 | 2020-03-01 |
| 1518598317 | Guadalupe Virginia Nabarrette | Non-emergency Medical Transport (VAN) | 301 Linda Vista Ln Apt 24, Taos, NM 87571-5149 | 2020-01-30 |
| 1366072407 | Turquiose Medical Transport LLC | Non-emergency Medical Transport (VAN) | 1321 E Highway 66, Gallup, NM 87301-4931 | 2020-01-16 |
| 1841837556 | Akram Mohamednour | Non-emergency Medical Transport (VAN) | 2105 S Espina St Apt 1, Las Cruces, NM 88001-5550 | 2019-12-02 |
| 1851934111 | Caregivers Transportation Inc. | Non-emergency Medical Transport (VAN) | 6300 Montano Rd Nw Suite F-3, Albuquerque, NM 87120-1826 | 2019-10-18 |
| 1194367482 | Vee Cares LLC | Non-emergency Medical Transport (VAN) | 1344 Walsh St Se, Rio Rancho, NM 87124-2979 | 2019-10-08 |
| 1689225336 | Med Lift, Inc. | Non-emergency Medical Transport (VAN) | 800 W Florida St, Deming, NM 88030-4563 | 2019-09-24 |
| Find all providers with the same taxonomy | ||||
| City | SANTO DOMINGO |
| Zip Code | 87052 |
Please comment or provide details below to improve the information on KEWA PUEBLO HEALTH CORPORATION.
| 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.