Organization
INDIAN HEALTH SERVICE- JICARILLA SERVICE UNIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM SUTTON (CEO)
(505) 759-3291
Entity
Organization
Contact information
Practice address
12000 STONE LAKE DRIVE, DULCE, NM 87528-0187
(505) 759-3291
Mailing address
PO BOX 804, DULCE, NM 87528-0804
(505) 759-0440
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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