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Organization
CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC
Active
Organization
CANONCITO BAND OF NAVAJOS HEALTH CENTER, INC
Active
Other names
Canoncito Band of Navajos Health Center, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER VARGA (LCDR/ CHIEF PHARMACIST)
(505) 908-2307
Entity
Organization
Contact information
Practice address
129 MEDICINE HORSE ROAD, CANONCITO, NM 87026
(505) 908-2307
(505) 908-2310
Mailing address
129 MEDICINE HORSE RD, CANONCITO, NM 87026
(505) 908-2307
(505) 908-2310
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
—
1124119698
—
NM
05
—
1205092160
—
NM
05
—
1295726073
—
NM
05
—
1619061090
—
TX
05
—
1962591669
—
NM
01
—
2166309
PK
—
Enumeration date
09/07/2016
Last updated
02/21/2017
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