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Organization
SANTA DOMINGO IHS PHARMACY
Active
Organization
SANTA DOMINGO IHS PHARMACY
Active
Other names
SANTA DOMINGO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA SCHWEITZER PHARMD (IHS PHARMACY CONSULTANT)
(602) 364-5277
Entity
Organization
Contact information
Practice address
340 SAN ILDEFONSO ST, SANTA DOMINGO, NM 87052
(505) 465-3060
(505) 465-1155
Mailing address
PO BOX 31001-0664, PASADENA, CA 91110-0664
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
01
—
3210399
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
B3725
—
NM
Enumeration date
03/26/2007
Last updated
04/05/2010
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