National Provider Identifier Database

PUEBLO OF ISLETA
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.


Contact Information

PUEBLO OF ISLETA
01 SAGEBRUSH ST
ISLETA, NM87022-0000
Phone: 505-869-4863
Fax: 505-869-4811
Website:
Specialty Taxonomy Code
* Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

* Indicates primary specialty

NPI Profile & details for PUEBLO OF ISLETA

NPI Number 1407979008
Legal business name
LBN
PUEBLO OF ISLETA
Authorized official VOLELLE ZAMORA - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/09/2007
Last updated 05/17/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: 501C
  • NM Medicaid: 00010146

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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