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General NPI Number Information
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NPI Number | 1073671194
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Entity Type | Organization
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Legal Business Name | PINE HILL HEALTH CENTER
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | BIA RT 125
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City | PINE HILL
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State | NM
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Zip | 87357
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Country | US
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Telephone | 505-775-3271
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Fax | 505-775-3633
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Provider Business Mailing Address
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Address Line | PHARMACY DEPT PO BOX 310
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City | PINE HILL
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State | NM
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Zip | 87357
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Country | US
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Telephone | 505-775-3271
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Fax | 505-775-3633
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | WILLIAM BECKER
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Credential |
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Telephone | 505-775-3271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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