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Organization
JICARILLA IHS PHARMACY
Active
Organization
JICARILLA IHS PHARMACY
Active
Other names
DULCE IHS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CUMMINGS PHARMD (PHARMACY PROGRAM SPECIALIST)
(405) 951-6086
Entity
Organization
Contact information
Practice address
500 N MUNDO DR, DULCE, NM 87528-5176
(505) 759-3291
(505) 759-3532
Mailing address
PO BOX 95447, CLEVELAND, OH 44101-0033
(575) 759-3291
(575) 759-3532
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
—
000K3526
—
NM
01
—
3210248
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/04/2007
Last updated
03/02/2023
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