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Contact Information

ZIA INDIAN HEALTH CLINIC PHARMACY
155B CAPITOL SQUARE DR
SAN YSIDRO, NM87053-6013
 Phone: 505-867-5258
 Fax: 505-771-9452
 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 ZIA INDIAN HEALTH CLINIC PHARMACY

NPI # 1225155666
LBN Legal business name ZIA INDIAN HEALTH CLINIC PHARMACY
Authorized official DARRELL MILLER - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/22/2007
Last updated 02/07/2025 - More than a year ago
Identifiers
NM Medicaid 11115
Other 3209269 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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