Provider Demographics
NPI:1578635199
Name:PHARMEX INC
Entity Type:Organization
Organization Name:PHARMEX INC
Other - Org Name:PINON FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-327-4826
Mailing Address - Street 1:2300 E 30TH ST BLDG B
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-8991
Mailing Address - Country:US
Mailing Address - Phone:505-327-4826
Mailing Address - Fax:505-327-4685
Practice Address - Street 1:2300 E 30TH ST BLDG B
Practice Address - Street 2:SUITE 101
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-8991
Practice Address - Country:US
Practice Address - Phone:505-325-8933
Practice Address - Fax:505-327-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NMPH000012423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3206198OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3206198OtherNCPDP PROVIDER IDENTIFICATION NUMBER