OrganizationActive
Kewa Pueblo Health Corporation
NPI 1467739888 · Federally Qualified Health Center (FQHC) · Santo Domingo Pueblo, NM
Provider details
- NPI number
- 1467739888
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Kewa Pueblo Health Corporation
- Organization subpart
- Yes
- Authorized official
- Jimmie Charlie, Chief Medical Officer(505) 465-3060
- License
- 03217726007 (NM)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
85 W Highway 22
Santo Domingo Pueblo, NM 87052-0559
Phone: (505) 465-3060
Fax: (505) 465-1191
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 559
Santo Domingo Pueblo, NM 87052-0559
Other names (DBA / former)
- Other name
- Santo Domingo Health Center
- Other name
- Santo Domingo Health Center
Registry dates
- Enumerated
- 2011-11-14
- Last updated
- 2024-02-22
- Certified
- 2024-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.