NPIMap

Organization Active NPI

Jicarilla IHS Pharmacy

Doing business as Dulce IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
National Provider Identifier
1124220900
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
JICARILLA IHS PHARMACY
Doing business as
Dulce IHS Pharmacy
Practice address
500 N Mundo Dr
Dulce, NM 87528-5176
Phone
(505) 759-3291
Fax
(505) 759-3532
NPI assigned
Jun 4, 2007
Last updated
Mar 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Cummings, PHARMD
Title
Pharmacy Program Specialist
Phone
(405) 951-6086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

500 N Mundo Dr
Dulce, NM 87528-5176

Mailing address

PO Box 95447
Cleveland, OH 44101-0033
Phone (575) 759-3291

Other identifiers 2

IdentifierTypeStateIssuer
3210248OtherNCPDP PROVIDER IDENTIFICATION NUMBER
000K3526MedicaidNM

Other names 1

  • DULCE IHS PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dulce Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 82

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 82

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1124220900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95447",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441010033",
            "telephone_number": "575-759-3291",
            "fax_number": "575-759-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MUNDO DR",
            "city": "DULCE",
            "state": "NM",
            "postal_code": "875285176",
            "telephone_number": "505-759-3291",
            "fax_number": "505-759-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JICARILLA IHS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACY PROGRAM SPECIALIST",
        "authorized_official_telephone_number": "405-951-6086",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3210248",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000K3526",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DULCE IHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DULCE IHS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dulce, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.