Active NPI
Southern Ute Indian Tribe
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Ignacio, CO
National Provider Identifier
1073630174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Legal business name
- SOUTHERN UTE INDIAN TRIBE
- Practice address
- 123 Weeminuche
Ignacio, CO 81137 - Phone
- (970) 563-4781
- Fax
- (970) 563-0207
- NPI assigned
- Mar 23, 2007
- Last updated
- Aug 4, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carole Velasco
- Title
- Health Center Director
- Phone
- (970) 563-4742
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | Primary |
Addresses
Primary practice location
123 Weeminuche
Ignacio, CO 81137
Mailing address
Pharmacy Dept
PO Box 899
Ignacio, CO 81137
Phone (970) 563-4581
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 67553541 | Medicaid | CO | |
| 2003394 | Other | PK |
National Provider Directory
National Provider Directory- Tax ID family
- Southern Ute Indian Tribe
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Ignacio, CO
- NPI 1164881686
-
- Federally Qualified Health Center (FQHC)
- Ignacio, CO
- NPI 1407883309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659571200000",
"number": "1073630174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PHARMACY DEPT",
"address_2": "PO BOX 899",
"city": "IGNACIO",
"state": "CO",
"postal_code": "81137",
"telephone_number": "970-563-4581",
"fax_number": "970-563-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 WEEMINUCHE",
"city": "IGNACIO",
"state": "CO",
"postal_code": "81137",
"telephone_number": "970-563-4781",
"fax_number": "970-563-0207"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN UTE INDIAN TRIBE",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-23",
"last_updated": "2022-08-04",
"certification_date": "2022-08-04",
"status": "A",
"authorized_official_last_name": "VELASCO",
"authorized_official_first_name": "CAROLE",
"authorized_official_title_or_position": "HEALTH CENTER DIRECTOR",
"authorized_official_telephone_number": "970-563-4742"
},
"taxonomies": [
{
"code": "332800000X",
"taxonomy_group": "",
"desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "67553541",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2003394",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ignacio, CO
- June Barrie Santon, M.A.
- Lisa Smith, RDN
- Southern Colorado Community Action Agency, Inc.
- Southern Colorado Ute Health Center Ias
- Southern Colorado Ute Service Unit (Southern Ute Health Center)
- Southern Ute Indian Tribe
- Southern Ute Indian Tribe
- Stephen Matthew Stockhausen, PT, DPT
- Sucap
- Tia Gabrielle Swanemyr, CST/CSFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.