Healthcare Provider Details

I. General information

NPI: 1821322280
Provider Name (Legal Business Name): FIRST NATIONS COMMUNITY HEALTHSOURCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 ZUNI RD SE
ALBUQUERQUE NM
87108-2926
US

IV. Provider business mailing address

5608 ZUNI RD SE
ALBUQUERQUE NM
87108-2926
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-6580
  • Fax:
Mailing address:
  • Phone: 505-262-2580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNM

VIII. Authorized Official

Name: DR. LINDA SON-STONE
Title or Position: DIRECTOR
Credential: PHD
Phone: 505-262-6546