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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