| Organization Name: | SANDIA PHS HEALTH CENTER |
| NPI Number: | 1225150535 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PEDRO SOLIS (PHARMACY DIRECTOR, ACTING) |
| Mailing Address: | 481 Sandia Loop Bernalillo |
| State: | NM US |
| Postal Code: | 870047076 |
| Phone Number: | 5052484028 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP0904X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Public Health, Federal |
| Taxonomy Definition: | |