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General NPI Number Information
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NPI Number | 1700070364
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Entity Type | Organization
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Legal Business Name | SANTA FE INDIAN HOSPITAL
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 08/28/2007
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Provider Practice Location Address
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Address Line | 1700 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505-3554
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Country | US
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Telephone | 505-946-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505-3554
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Country | US
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Telephone | 505-946-9390
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Fax |
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Authorized Official
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Title or Position | CLINICAL RD
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Name | MS. CECILIA BUTLER
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Credential | MS,RD,CDE
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Telephone | 505-946-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 389
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License Number State | NM
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