JICARILLA IHS PHARMACY NPI 1124220900

NPI Information

NPI: 1124220900
Provider Name: JICARILLA IHS PHARMACY
Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
Entity Type: Organization
Doing Business As: DULCE IHS PHARMACY
CLIA Number: 32D2325550
Address: 500 N MUNDO DR
DULCE, NM
ZIP 87528
Phone: (505) 759-3291

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NPI Details

JICARILLA IHS PHARMACY is an indian health service tribal urban indian health i t u pharmacy in Dulce, NM. The provider is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. JICARILLA IHS PHARMACY NPI is 1124220900. The provider is registered as an organization entity type.
The provider Is Doing Business As Dulce Ihs Pharmacy.

The provider's business location address is:

500 N MUNDO DR
DULCE, NM
ZIP 87528-176
Phone: (505) 759-3291
Fax: (505) 759-3532

The provider's authorized official is James Cummings .
The authorized official title is Pharmacy Program Specialist and has the following contact phone number (405) 951-6086.

The CLIA number assigned to this NPI record is 32D2325550 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/4/2007 and was last updated on 3/2/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332800000X	Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000K3526	MEDICAID	NEW MEXICO
2	3210248	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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