Organization · Type 2 NPI
Jicarilla Ihs Pharmacy
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Dulce, NM
Practice location
500 N Mundo Dr
Dulce, NM 87528-5176
Fax (505) 759-3532
Mailing address
PO Box 95447
Cleveland, OH 44101-0033
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.
4 other providers at this address
About NPI 1124220900
Jicarilla Ihs Pharmacy's National Provider Identifier is 1124220900, issued on Jun 4, 2007. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Dulce, NM. The record was last updated on Mar 2, 2023.