Zia Indian Health Clinic Pharmacy

Primary specialty

Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X

Legal business name

ZIA INDIAN HEALTH CLINIC PHARMACY

Doing business as

Zia Indian Health Clinic Pharmacy

Practice address

155B Capitol Square Dr
San Ysidro, NM 87053-6013

Phone

(505) 867-5258

Fax

(505) 771-9452

NPI assigned

Mar 22, 2007

Last updated

Feb 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darrell Miller

Title

Chief Executive Officer

Phone

(505) 248-7773

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ZIA INDIAN HEALTH CLINIC PHARMACY Doing business as

Practitioners 2

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.

• Sharla Garcia, RDH

  • Dental Hygienist
  • Zia Pueblo, NM
  • NPI 1033421086
  NPD (past)
• Dolores Jean Millard, RDH

  • Dental Hygienist
  • Zia Pueblo, NM
  • NPI 1174848543
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1225155666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95459",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441010033",
            "telephone_number": "505-248-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155B CAPITOL SQUARE DR",
            "city": "SAN YSIDRO",
            "state": "NM",
            "postal_code": "870536013",
            "telephone_number": "505-867-5258",
            "fax_number": "505-771-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIA INDIAN HEALTH CLINIC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "505-248-7773"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3209269",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11115",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZIA INDIAN HEALTH CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• New Mexico Mountain Healthcare
• Paula S Practice (San Ysidro Health Clinic)

• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in San Ysidro, NM
• Providers in San Ysidro, NM by specialty
• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.