Pueblo of Jemez

Primary specialty

Federal Public Health Clinic/CenterTaxonomy code 261QP0904X

Legal business name

PUEBLO OF JEMEZ

Doing business as

Jemez Health Center Pharmacy

Practice address

110 Sheepsprings Way
Jemez Pueblo, NM 87024

Phone

(575) 834-0130

NPI assigned

Apr 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nohemy Rosales

Title

Business Office Manager

Phone

(575) 834-3187

Specialties & licenses 1

Addresses

Other names 1

• Jemez Health Center Pharmacy Doing business as

Tax ID family

Pueblo of Jemez2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pueblo of Jemez

  • Clinic/Center
  • Jemez Pueblo, NM
  • NPI 1225346547
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1477676567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "870240279",
            "telephone_number": "575-831-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SHEEPSPRINGS WAY",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "87024",
            "telephone_number": "575-834-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO OF JEMEZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "ROSALES",
        "authorized_official_first_name": "NOHEMY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "575-834-3187"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jemez Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cristina Medrano-Parson, PHARMD
• Marietta Montoya, P.T.
• Peter Paul Pecos, LADC
• Pueblo of Jemez
• Pueblo of Jemez
• Pueblo of Jemez
• Guadalupe Renee Rosas, R.T.
• Alyssa Monique Sandia
• Tanya Lee Shendo
• Mark Joseph Stevens, D.O.

• Clinic/Center in Jemez Pueblo, NM
• Providers in Jemez Pueblo, NM by specialty
• Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.

Verify at the official NPI Registry.