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Organization
DHHS IHS PHOENIX AREA
Active
Organization
DHHS IHS PHOENIX AREA
Active
Other names
SAN CARLOS INDIAN HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUMMINGS PHARMD (PHARMACY PROGRAM SPECIALIST)
(405) 951-6086
Entity
Organization
Contact information
Practice address
238 CIBECUE CIRCLE, SAN CARLOS, AZ 85550
(928) 475-7270
(928) 475-7376
Mailing address
PO BOX 31001-0702, PASADENA, CA 91110-0702
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020553
—
AZ
01
—
0325743
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/22/2007
Last updated
03/05/2013
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