| Gallup Indian Medical Center | |
|
516 Nizhoni Blvd Gallup NM 87301-5748 | |
| (505) 722-1000 | |
| (505) 722-1310 |
| Full Name | Gallup Indian Medical Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 516 Nizhoni Blvd, Gallup, New Mexico |
| Authorized Official Name and Position | Bennie C Yazzie (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5057221403 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallup Indian Medical Center Po Box 1337 Gallup NM 87305-1337 Ph: (505) 722-1000 | Gallup Indian Medical Center 516 Nizhoni Blvd Gallup NM 87301-5748 Ph: (505) 722-1000 |
| NPI Number | 1740452697 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 07/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740452697 | NPI | - | NPPES |
| 1507755 | Other | NM | UCC GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 9435 (* (Not Available)) | Primary |
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