Active NPI
Pueblo of Sandia
Doing business as Sandia Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Bernalillo, NM
National Provider Identifier
1609116573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Legal business name
- PUEBLO OF SANDIA
- Doing business as
- Sandia Pharmacy
- Practice address
- 203 Sandia Day School Road
Bernalillo, NM 87004-7076 - Phone
- (505) 867-4696
- Fax
- (505) 867-4997
- NPI assigned
- Feb 28, 2013
- Last updated
- Oct 1, 2015
- 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
- Ms. Carrie Sarnicky, MBA
- Title
- Director, Health and Social Service
- Phone
- (505) 867-4696
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | NU | Primary |
Addresses
Primary practice location
203 Sandia Day School Road
Bernalillo, NM 87004-7076
Mailing address
481 Sandia Loop
Bernalillo, NM 87004-7076
Phone (505) 867-4696
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00010462 | Medicaid | NM | |
| TRZ029 | Other | PTAN |
Other names 1
- Sandia Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Pueblo of Sandia
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Sandia Health Center
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Bernalillo, NM
- NPI 1548588643
Locations
481 Sandia Loop
Sandia Pueblo, NM 87004
Phone (505) 867-4696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1443657600000",
"number": "1609116573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "481 SANDIA LOOP",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870047076",
"telephone_number": "505-867-4696",
"fax_number": "505-867-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 SANDIA DAY SCHOOL ROAD",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870047076",
"telephone_number": "505-867-4696",
"fax_number": "505-867-4997"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUEBLO OF SANDIA",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-28",
"last_updated": "2015-10-01",
"status": "A",
"authorized_official_last_name": "SARNICKY",
"authorized_official_first_name": "CARRIE",
"authorized_official_title_or_position": "DIRECTOR, HEALTH AND SOCIAL SERVICE",
"authorized_official_telephone_number": "505-867-4696",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "332800000X",
"taxonomy_group": "",
"desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00010462",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "TRZ029",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sandia Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bernalillo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.