Organization
PUEBLO OF ISLETA
Active
Other names
PUEBLO OF ISLETA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VOLELLE K ZAMORA (CEO)
(505) 869-4094
Entity
Organization
Contact information
Practice address
01 SAGEBRUSH ST, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4811
Mailing address
01 SAGEBRUSH ST, ISLETA, NM 87022-0000
(505) 869-4863
(505) 869-4811
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
501C
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010146
—
NM
Enumeration date
04/09/2007
Last updated
05/17/2017
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