Indian Health Service- Jicarilla Service Unit
NPI #1477628659 in Dulce, New Mexico
Provider Information
- NPI Number
- 1477628659
- Entity Type
- Organization
- Organization Name
- Indian Health Service- Jicarilla Service Unit
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Nov 22, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 12000 STONE LAKE DRIVE
- City
- Dulce
- State
- New Mexico
- ZIP Code
- 87528-0187
- Phone
- (505) 759-3291
Authorized Official
- Name
- MR. JIM SUTTON
- Title
- CEO
- Phone
- (505) 759-3291
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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