Provider Demographics
NPI:1407343445
Name:AMADOR HEALTH CENTER, INC.
Entity type:Organization
Organization Name:AMADOR HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERINMA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANYANKAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:575-527-5482
Mailing Address - Street 1:PO BOX 2243
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-2243
Mailing Address - Country:US
Mailing Address - Phone:575-527-5482
Mailing Address - Fax:866-744-9513
Practice Address - Street 1:999 W AMADOR AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2739
Practice Address - Country:US
Practice Address - Phone:575-527-5482
Practice Address - Fax:575-652-4243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMADOR HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-16
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCL000063503336C0002X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM86787098Medicaid