ACOMA CANONCITO LAGUNA INDIAN; NPI #1649462532

Contact Information

ACOMA CANONCITO LAGUNA INDIAN

EXIT 102 OFF I-40 1/2 MI SOUTH
SAN FIDEL, NM 87049-0130

Phone: 505-552-5385
Fax: 505-552-5490
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for ACOMA CANONCITO LAGUNA INDIAN

NPI Number 1649462532

LBN Legal business name ACOMA CANONCITO LAGUNA INDIAN

Authorized official BARBARA FELIPE - (ACL IHS CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/14/2007

Last updated 01/11/2012 - About 14 years ago

Identifiers

NM	License #	14909596
NM	Medicaid	14909596
	Other	320070	MEDICARE PART A

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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ACOMA CANONCITO LAGUNA INDIAN

Contact Information

Specialty

Ambulance

NPI Profile & details for ACOMA CANONCITO LAGUNA INDIAN

Reviews for ACOMA CANONCITO LAGUNA INDIAN