| Cbn Health Center, Inc | |
|
129 Medicine Horse Drive Tohajiilee NM 87026 | |
| (505) 908-2307 | |
| (505) 908-2310 |
| Full Name | Cbn Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 129 Medicine Horse Drive, Tohajiilee, New Mexico |
| Authorized Official Name and Position | Beverly Lewis (BUSINESS OFFICE) |
| Authorized Official Contact | 5059082307 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cbn Health Center, Inc 129 Medicine Horse Drive Tohajiilee NM 87026 Ph: (505) 908-2307 | Cbn Health Center, Inc 129 Medicine Horse Drive Tohajiilee NM 87026 Ph: (505) 908-2307 |
| NPI Number | 1578010070 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 02/01/2017 |
| Medicare PECOS PAC ID | 8325321235 |
|---|---|
| Medicare Enrollment ID | O20170425001197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578010070 | NPI | - | NPPES |
| 91286018 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Sheryl A O Shea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295726073 PECOS PAC ID: 4385540707 Enrollment ID: I20031208000845 |
| Provider Name | Kerry A Hile |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972683878 PECOS PAC ID: 6800796558 Enrollment ID: I20040109001052 |
| Provider Name | Ursula R Roblero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790888774 PECOS PAC ID: 6103857867 Enrollment ID: I20050823000698 |
| Provider Name | Christopher C Cordes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033318902 PECOS PAC ID: 7517053085 Enrollment ID: I20071013000012 |
| Provider Name | Donald W Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083773931 PECOS PAC ID: 4688749336 Enrollment ID: I20080815000087 |
| Provider Name | Robert C Salek |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164452207 PECOS PAC ID: 1153324454 Enrollment ID: I20081020000449 |
| Provider Name | Julianna J Reece |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083607634 PECOS PAC ID: 0143376590 Enrollment ID: I20090925000572 |
| Provider Name | Elizabeth B Cumby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962591669 PECOS PAC ID: 4587565403 Enrollment ID: I20120315000808 |
| Provider Name | Jon E Drake |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1124337803 PECOS PAC ID: 3274835962 Enrollment ID: I20160113000111 |
| Provider Name | Roberto C Montes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639523855 PECOS PAC ID: 8628360674 Enrollment ID: I20160712000993 |
| Provider Name | Noah A Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619061090 PECOS PAC ID: 5890727234 Enrollment ID: I20171009003304 |
| Provider Name | Emily Rothman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124119698 PECOS PAC ID: 9234037086 Enrollment ID: I20171206002318 |
| Provider Name | Jennifer M Pas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1356385751 PECOS PAC ID: 7911959275 Enrollment ID: I20210915001222 |
| Provider Name | Jory L Mazzola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255537593 PECOS PAC ID: 6406082312 Enrollment ID: I20230815000435 |
| Provider Name | Barbara V Lewis Heywood |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1265416069 PECOS PAC ID: 9436563574 Enrollment ID: I20230823002946 |
| Provider Name | Michael R Craddock |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1871541276 PECOS PAC ID: 1951764497 Enrollment ID: I20230830003412 |
| Provider Name | Dathan Tsosie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174151914 PECOS PAC ID: 9931526423 Enrollment ID: I20231114001874 |
Canoncito Band Of Navajos Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 129 Medicine Horse Dr, Tohajiilee, NM 87026 Phone: 505-908-2307 Fax: 505-908-2310 |