Provider Demographics
NPI:1689236440
Name:ACP PHARMACY LLC
Entity Type:Organization
Organization Name:ACP PHARMACY LLC
Other - Org Name:ALAMOGORDO COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:575-223-0795
Mailing Address - Street 1:1003 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6425
Mailing Address - Country:US
Mailing Address - Phone:575-223-0795
Mailing Address - Fax:575-446-0073
Practice Address - Street 1:1003 10TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6425
Practice Address - Country:US
Practice Address - Phone:575-223-0795
Practice Address - Fax:575-446-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1821580416Medicaid