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Contact Information

JICARILLA IHS PHARMACY
500 N MUNDO DR
DULCE, NM87528-5176
 Phone: 505-759-3291
 Fax: 505-759-3532
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for JICARILLA IHS PHARMACY

NPI Number 1124220900
LBN Legal business name JICARILLA IHS PHARMACY
Authorized official JAMES CUMMINGS - (PHARMACY PROGRAM SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 06/04/2007
Last updated 03/02/2023 - About 3 years ago
Identifiers
NM Medicaid 000K3526
Other 3210248 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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