Canoncito Community Clinic
Organization Active NPI General Acute Care Hospital · San Fidel, NM
NPI 1841365558 · NPPES record last updated Jan 9, 2012
Key facts
- NPI
- 1841365558
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- CANONCITO COMMUNITY CLINIC
- Practice address
- Exit #131 Off I 40 6 Miles North
San Fidel, NM 87049-0130 - Phone
- (505) 552-5385
- Fax
- (505) 552-5828
- NPI assigned
- Nov 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Barbara Felipe
- Title
- Acl IHS Ceo
- Phone
- (505) 552-5303
Practitioners 7
-
Melissa M Salinas, PAC
-
Albert R. Zavatsky, M.D.
-
Dennis Deziel, M.D.
-
Rick Stoltenburg, PA
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
Exit #131 Off I 40 6 Miles North
San Fidel, NM 87049-0130
Mailing address
Acoma Canoncito Laguna Indian Hospital
PO Box 130
San Fidel, NM 87049
Phone (505) 552-5385
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320070 | Other | NM | RAILROAD MEDICARE |
| HSZ022 | Other | NM | RAILROAD MEDICARE |
| L9815 | Medicaid | NM |
Other names
- DHHS USPHS INDIAN HEALTH SERVICES
Other providers in San Fidel, NM
- Acoma Canoncito Laguna Indian
- Larry Alonso
- Michael Christopher Barrett
- Thomas Barton
- Robert B Bowlin
- Vicky J Chee
- Lisa Ann Cohn
- Carol Rose Cummins
- Wilbert Darwin
- Olowan D Deherrera
All providers in San Fidel, NM · General Acute Care Hospital in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.