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Organization

ZIA INDIAN HEALTH CLINIC PHARMACY

Active
Other names
ZIA INDIAN 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
155B CAPITOL SQUARE DR, SAN YSIDRO, NM 87053-6013
(505) 867-5258
(505) 771-9452
Mailing address
PO BOX 95459, 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
11115
NM
01
3209269
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
03/22/2007
Last updated
02/07/2025
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