Provider Demographics
NPI:1902373970
Name:BESTCARE PHARMACY TUCUMCARI LLC
Entity Type:Organization
Organization Name:BESTCARE PHARMACY TUCUMCARI LLC
Other - Org Name:BESTCARE PHARMACY TUCUMCARI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:POTHULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-675-2012
Mailing Address - Street 1:511 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCUMCARI
Mailing Address - State:NM
Mailing Address - Zip Code:88401-2861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:511 S 2ND ST
Practice Address - Street 2:
Practice Address - City:TUCUMCARI
Practice Address - State:NM
Practice Address - Zip Code:88401-2861
Practice Address - Country:US
Practice Address - Phone:575-461-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy