| Jicarilla Health Care Facility | |
|
12000 Stone Lake Rd Dulce NM 87528 | |
| (505) 759-7286 | |
| Not Available |
| Full Name | Jicarilla Health Care Facility |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 12000 Stone Lake Rd, Dulce, New Mexico |
| Authorized Official Name and Position | Thomas T Pryor (PUBLIC HEALTH NURSE) |
| Authorized Official Contact | 5057597286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jicarilla Health Care Facility Po Box 1144 Pagosa Springs CO 81147-1144 Ph: () - | Jicarilla Health Care Facility 12000 Stone Lake Rd Dulce NM 87528 Ph: (505) 759-7286 |
| NPI Number | 1003820069 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003820069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Oregon) | Primary |
Dulce Teen Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Hawks Dr, Dulce, NM 87528 Phone: 575-759-2924 Fax: 575-759-1349 | |
Dhhs/ihs/aao/jsu/dulce Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12000 Stone Lake Road, Jicarilla Service Unit, Dulce, NM 87528 Phone: 575-759-3291 Fax: 575-759-3532 | |
Jicarilla Service Unit Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 North Mundo, Dulce, NM 87528 Phone: 505-759-3291 Fax: 505-759-3532 |