Healthcare Provider Details

I. General information

NPI: 1407343445
Provider Name (Legal Business Name): AMADOR HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 W AMADOR AVE STE A
LAS CRUCES NM
88005-2739
US

IV. Provider business mailing address

PO BOX 2243
LAS CRUCES NM
88004-2243
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-5482
  • Fax: 575-652-4243
Mailing address:
  • Phone: 575-527-5482
  • Fax: 866-744-9513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberCL00006350
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ERINMA N ANYANKAH
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 575-527-5482