Organization
ACOMA CANONCITO LAGUNA PHARMACY
Active
Other names
ACL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
INNA VOINICH PHARMD (CHIEF PHARMACIST)
(505) 552-5393
Entity
Organization
Contact information
Practice address
80 B VETERANS BLVD, ACOMA, NM 87034-8703
(505) 552-5393
(505) 552-5484
Mailing address
PO BOX 95475, CLEVELAND, OH 44101-0033
(505) 552-5394
(505) 552-5464
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3209245
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
H3451
—
NM
Enumeration date
03/13/2007
Last updated
02/10/2025
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