Organization
SANTA ANA HEALTH CLINIC PHARMACY
Active
Other names
SANTA ANA HEALTH CLINIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL MILLER (CHIEF EXECUTIVE OFFICER)
(505) 248-7773
Entity
Organization
Contact information
Practice address
02 C DOVE RD, BERNALILLO, NM 87004
(505) 867-2497
(505) 867-1526
Mailing address
PO BOX 95458, CLEVELAND, OH 44101-0033
(505) 248-7771
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
—
11237
—
NM
01
—
3209271
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/12/2007
Last updated
02/07/2025
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