PINE HILL HEALTH CENTER (NPI# 1073671194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073671194 |
Entity Type | Organization |
Organization Name | PINE HILL HEALTH CENTER |
Other Organization Name | PINE HILL HEALTH CENTER |
Practice Address |
Bia Rt 125 Pine Hill NM 87357 |
Mailing Address |
Pharmacy Dept Po Box 310 Pine Hill NM 87357 |
Practice Telephone | 5057753271 |
Practice Fax Number | 5057753633 |
Mailing Telephone | 5057753271 |
Mailing Fax Number | 5057753633 |
Enumeration Date | 2006-12-04 |
Last Update Date | 2020-09-14 |
Authorized Official Name | WILLIAM BECKER (CLINIC ADMINISTRATOR) |
Authorized Official Telephone | 5057753271 |
Authorized Official Credential | PHARMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 69964 | 05 | |
PK | 2058706 | 01 | |
NM | 55587 | 05 |
Other Name | Type Code |
---|---|
PINE HILL HEALTH CENTER | Doing Business As Name - Organization |
Street Address |
BIA RT 125 |
City | PINE HILL |
State | NM |
Zip Code | 87357 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659996031 | Siamak Mollaei | Pharmacist | Bureau of Indian Affair Route 125, Pinehill, NM 87357 | 2020-06-11 |
1205450939 | Aislinn B Grover | Dental Hygienist | Indian Service Rte 140 & Indian Service Route 125, Pinehill, NM 87357 | 2020-05-28 |
1285286419 | Myeshia La'tway Carroll | Nurse Practitioner | Indian Service Rte 140 & Indian Service Rte 125, Pine Hill, NM 87357 | 2019-07-09 |
1659735140 | Jennifer John Charley | Counselor | 15 Behavioral Health Rd, Pinehill, NM 87357 | 2016-04-11 |
1639421001 | Vicki Andrea Winter | Pharmacist | Bia Route 140, Pinehill, NM 87357 | 2012-10-10 |
1043535388 | Pearl A Alonzo | Registered Nurse | Bia 125, Pine Hill Health Center, Pine Hill, NM 87357 | 2010-03-30 |
1306047527 | Michael John Nolan | Physician Assistant | 310 Pine Hill, Pine Hill, NM 87357 | 2007-05-29 |
1649488255 | Ivan John Christov Nicolov | Family Medicine | Bia Rte 125, Pine Hill, NM 87357 | 2007-05-18 |
1316066244 | Jill Sanders | Pharmacist | 125 Bia Route, Pine Hill Health Center, Pine Hill, NM 87357 | 2007-03-29 |
1720175581 | Kristi Michelle Turney | Pharmacist | Pine Hill Health Center, Bia Route 125, Pine Hill, NM 87357 | 2006-10-05 |
Find all providers in zip 87357 |
Taxonomy Code | 332800000X |
Grouping | Suppliers |
Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
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. |
Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629525605 | Canoncito Band of Navajos Health Center, Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 129 Medicine Horse Road, Canoncito, NM 87026 | 2016-09-07 |
1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
1225155666 | Zia Indian Health Clinic Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 155b Capitol Square Dr, San Ysidro, NM 87053-6013 | 2007-03-22 |
1154453413 | Santa Ana Health Clinic Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 02 C Dove Rd, Bernalillo, NM 87004 | 2007-03-12 |
1023148608 | Crownpoint Health Care Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Hwy Jct 57 Rt 9, Crownpoint, NM 87313-0358 | 2007-03-06 |
1750425484 | Mescalero Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 318 Abalonie Loop, Mescalero, NM 88340 | 2007-02-16 |
1609116573 | Pueblo of Sandia | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 203 Sandia Day School Road, Bernalillo, NM 87004-7076 | 2013-02-28 |
1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
1124220900 | Jicarilla Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 12000 Stone Lake Rd, Dulce, NM 87528 | 2007-06-04 |
1407979008 | Pueblo of Isleta | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 01 Sagebrush St, Isleta, NM 87022-0000 | 2007-04-09 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.