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Jicarilla Ihs Pharmacy
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Dulce, New Mexico
NPI 1124220900

Jicarilla Ihs Pharmacy is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Cleveland, NM. Jicarilla Ihs Pharmacy practices in Dulce, NM. The NPI Number for Jicarilla Ihs Pharmacy is 1124220900 and holds a License No. (New Mexico).

The current practice location address for Jicarilla Ihs Pharmacy is 500 N Mundo Dr, Dulce, NM and can be reached out via phone at 505-759-3291 and via fax at 505-759-3532. You can also correspond with Jicarilla Ihs Pharmacy through the mailing address at PO BOX 95447, CLEVELAND, OH - 44101-0033 (mailing address contact number: 575-759-3291).

Location: 500 N Mundo Dr, Dulce, NM, 44101-0033
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1124220900
Provider Name
Jicarilla Ihs Pharmacy
Credential
Provider Entity Type
Organization
Address
500 N Mundo Dr, Dulce, NM, 44101-0033
Phone Number
505-759-3291
Fax Number
505-759-3532
Provider Enumeration Date
06/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000K3526 05 NM
3210248 01 NCPDP PROVIDER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
500 N Mundo Dr
City
Dulce
State
New Mexico
Zip
87528-5176
Phone Number
505-759-3291
Fax Number
505-759-3532
person
Provider Business Mailing Address Details
Address
500 N Mundo Dr
City
Dulce
State
New Mexico
Zip
87528-5176
Phone Number
505-759-3291
Fax Number
505-759-3532
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
()
Definition
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.
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