Provider Demographics
NPI:1073384640
Name:PHARMCARE USA OF NEW MEXICO LLC
Entity Type:Organization
Organization Name:PHARMCARE USA OF NEW MEXICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARNEY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:ABBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-204-9783
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:HYDRO
Mailing Address - State:OK
Mailing Address - Zip Code:73048-0010
Mailing Address - Country:US
Mailing Address - Phone:866-219-3619
Mailing Address - Fax:
Practice Address - Street 1:8500 JEFFERSON ST NE STE D
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1884
Practice Address - Country:US
Practice Address - Phone:505-856-1660
Practice Address - Fax:505-856-7141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy