Organization · Type 2 NPI

Kewa Pueblo Health Corporation

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Santo Domingo, NM

NPI number 1194002345 Active

Practice location

85 W Highway 22
Santo Domingo, NM 87052-0340

Call (505) 465-3060 Map

Fax (505) 318-1079

Mailing address

PO Box 559
Santo Domingo Pueblo, NM 87052-0559

Specialties and licenses

Taxonomy	Code	License
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary	332800000X	None listed

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy: An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.

15 other providers at this address

NPI record

NPI: 1194002345
Entity type: Organization (Type 2)
Issued: Nov 15, 2011
Last updated: Mar 18, 2026
Status: Active
Subpart: Yes of Kewa Pueblo Health Corporation

Other names

<unavail>
Santo Domingo Health Center · doing business as
Santo Domingo Health Center · doing business as

Authorized official

Paul Ray Gurule
Chief Financial Officer
(505) 465-3060

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1194002345

Kewa Pueblo Health Corporation's National Provider Identifier is 1194002345, issued on Nov 15, 2011. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Santo Domingo, NM. The record was last updated on Mar 18, 2026.