Provider Demographics
NPI:1194533562
Name:ZIA FAMILY HEALTH AND PHARMACY
Entity type:Organization
Organization Name:ZIA FAMILY HEALTH AND PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:POLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:575-263-2908
Mailing Address - Street 1:305 E SANGER ST STE 600
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-4405
Mailing Address - Country:US
Mailing Address - Phone:575-263-2908
Mailing Address - Fax:575-263-2909
Practice Address - Street 1:305 E SANGER ST STE 600
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4405
Practice Address - Country:US
Practice Address - Phone:575-263-2908
Practice Address - Fax:575-263-2909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZIA FAMILY HEALTH AND PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center