Provider Demographics
NPI:1821580416
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:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-620-2868
Mailing Address - Street 1:1003 10TH STREET
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:505-620-2868
Practice Address - Fax:505-620-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336C0004X, 3336H0001X, 3336L0003X, 3336M0003X, 3336S0011X
NMPH000046153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177773OtherPK