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Contact Information

PUEBLO OF SANDIA
203 SANDIA DAY SCHOOL ROAD
BERNALILLO, NM87004-7076
 Phone: 505-867-4696
 Fax: 505-771-5107
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
 

Community Health

261QC1500X
Indicates primary specialty

NPI Profile & details for PUEBLO OF SANDIA

NPI # 1548588643
LBN Legal business name PUEBLO OF SANDIA
Authorized official GWENDOLYN WASETA - (BUSINESS OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/13/2010
Last updated 05/22/2025 - More than a year ago
Identifiers
NM Medicaid 35922079
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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