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Pueblo of San Felipe

Organization Active NPI Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · San Felipe, NM

NPI 1467550475 · NPPES record last updated Jun 11, 2018

Key facts

NPI
1467550475
Entity type
Organization (NPI type 2)
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Legal business name
PUEBLO OF SAN FELIPE
Practice address
3 Cedar St
San Felipe Pueblo
San Felipe, NM 87001
Phone
(505) 867-5485
Fax
(505) 771-9940
NPI assigned
Sep 21, 2006
Organization subpart
No

Authorized official

Name
Daryl Candelaria, PHARMD RPH
Title
Tribal Admin
Phone
(505) 867-3381

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

  • Rudy Tafoya, LCSW Social Worker · Albuquerque, NM · NPI 1003049248
    NPD

National Provider Directory

Tax ID family
Pueblo of San Felipe (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Yes
Pharmacy 333600000X

Addresses

Primary practice location

3 Cedar St
San Felipe Pueblo
San Felipe, NM 87001

Mailing address

PO Box 4342
PO Box 4339
San Felipe, NM 87001
Phone (505) 867-9616

Other identifiers

IdentifierTypeStateIssuer
81271875MedicaidNM
2058717OtherPK

Other names

  • SAN FELIPE HEALTH CLINIC PHCY Doing business as

Other providers in San Felipe, NM

All providers in San Felipe, NM · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in New Mexico

Sources for this page

Verify at the official NPI Registry.