Organization
TAOS PICURIS HEALTH CENTER
Active
Other names
TAOS PICURIS HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KAILEE FRETLAND PHARMD (PRINCIPAL PHARMACY CONSULTANT)
(240) 478-2245
Entity
Organization
Contact information
Practice address
1090 GOAT SPRINGS RD, TAOS, NM 87571
(575) 758-6995
(505) 751-5211
Mailing address
PO BOX 95452, CLEVELAND, OH 44101-0033
(575) 758-6995
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
01
—
2058715
PK
—
05
—
B4347
—
NM
Enumeration date
03/23/2007
Last updated
07/30/2024
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