Taos Picuris Health Center

Primary specialty

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

Legal business name

TAOS PICURIS HEALTH CENTER

Doing business as

Taos Picuris Health Center Pharmacy

Practice address

1090 Goat Springs Rd
Taos, NM 87571

Phone

(575) 758-6995

Fax

(505) 751-5211

NPI assigned

Mar 23, 2007

Last updated

Jul 30, 2024By 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

Kailee Fretland, PHARMD

Title

Principal Pharmacy Consultant

Phone

(240) 478-2245

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• TAOS PICURIS HEALTH CENTER 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.

• Carmine Dimartino, M.D.

  • Family Medicine Physician
  • Taos, NM
  • NPI 1689995953
  NPD
• Robert Krueger, PH.D., FICPP

  • Clinical Psychologist
  • Taos, NM
  • NPI 1558575571
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1790802890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95452",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441010033",
            "telephone_number": "575-758-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 GOAT SPRINGS RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-6995",
            "fax_number": "505-751-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS PICURIS HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "FRETLAND",
        "authorized_official_first_name": "KAILEE",
        "authorized_official_title_or_position": "PRINCIPAL PHARMACY CONSULTANT",
        "authorized_official_telephone_number": "240-478-2245",
        "authorized_official_credential": "PHARMD"
    },
    "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B4347",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TAOS PICURIS HEALTH CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAOS PICURIS HEALTH CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Taos Professional Services, LLC
• Taos Professional Services,LLC
• Taos Pueblo Behavioral Health
• Taos Pueblo Behavioral Health
• Taos Pueblo CMS Administration

• Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Taos, NM
• Providers in Taos, 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 Jul 30, 2024; 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.