ACOMA CANONCITO LAGUNA IHS PHARMACY (NPI# 1881727873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881727873 |
| Entity Type | Organization |
| Organization Name | ACOMA CANONCITO LAGUNA IHS PHARMACY |
| Other Organization Name | ACL PHARMACY |
| Practice Address |
1 40 Exit 203 Acomita San Fidel NM 87049 |
| Mailing Address |
Pharmacy Dept Po Box 130 San Fidel NM 87049 |
| Practice Telephone | 5055525393 |
| Practice Fax Number | 5055525484 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2013-03-07 |
| Authorized Official Name | JAMES CUMMINGS (PHARMACY PROGRAM SPECIALIST) |
| Authorized Official Telephone | 4059516086 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3209245 | 01 | |
| NM | 68376 | 05 | |
| NM | H3451 | 05 |
| Other Name | Type Code |
|---|---|
| ACL PHARMACY | Doing Business As Name - Organization |
| Street Address |
1 40 EXIT 203 ACOMITA |
| City | SAN FIDEL |
| State | NM |
| Zip Code | 87049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669937074 | James Blythe | Pharmacist | 80 Veterens Blvd, Acoma, NM 87049 | 2019-02-11 |
| 1689185571 | Jullliene Reed-tso | Social Worker | New Sunrise Rtc 20 Mockingbird Drive, San Fidel, NM 87049 | 2017-10-18 |
| 1245635309 | Donna Enfield | Counselor | Exit 102 1/2 Mi S of I-40, San Fidel, NM 87049 | 2014-10-30 |
| 1336425826 | Jodi Gee | Pharmacist | Acl Hospital Pharmacy Dept. I-40 @ Exit 102 (acomita), San Fidel, NM 87049 | 2011-10-27 |
| 1659528354 | Elaine Little | Dietitian, Registered | Acl Phs Indian Hospital, I - 40 Exit 102, San Fidel, NM 87049 | 2008-08-25 |
| 1366612830 | Lisa Ann Cohn | Pharmacist | Interstate 40 @ Exit 102, Acl Hospital Pharmacy Dept, San Fidel, NM 87049 | 2008-03-11 |
| 1619182821 | Melissa M Salinas | Physician Assistant | Exit 102 Off I-40 Half Mile S, San Fidel, NM 87049 | 2007-05-11 |
| 1083828453 | Edwina Faye Lee | Dental Hygienist | Exit 102 Off I40, 1/2 Mi South, San Fidel, NM 87049 | 2007-05-09 |
| 1730200171 | Carol Rose Cummins | Pharmacist | Interstate 40 Exit 102, San Fidel, NM 87049 | 2007-04-03 |
| 1740333160 | Us Dept. Health & Human Services - Usphs Indian Health Services | Substance Abuse Rehabilitation Facility | 20 Mockingbird Dr., San Fidel, NM 87049 | 2007-01-19 |
| Find all providers in zip 87049 | ||||
| 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 |
| 1073671194 | Pine Hill Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Bia Rt 125, Pine Hill, NM 87357 | 2006-12-04 |
| 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 |
| 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.