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Organization
ALBUQUERQUE INDIAN HEALTH PHARMACY
Active
Organization
ALBUQUERQUE INDIAN HEALTH PHARMACY
Active
Other names
ALBUQUERQUE INDIAN HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL MILLER (CHIEF EXECUTIVE OFFICER)
(505) 248-7773
Entity
Organization
Contact information
Practice address
801 VASSAR DR NE, ALBUQUERQUE, NM 87106-2725
(505) 248-7640
(505) 248-7642
Mailing address
PO BOX 95457, CLEVELAND, OH 44101-0033
(505) 248-7771
(505) 248-4019
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
—
3209283
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
74605
—
NM
Enumeration date
03/05/2007
Last updated
02/07/2025
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