MEDICARE: LAS CRUCES APOTHECARY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH000006912	NM

General Provider Information

NPI Number	:	1013309863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS CRUCES APOTHECARY

Provider Business Mailing Address
First Line	:	525 E MADRID AVE STE 8
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-1671
Country	:	US
Telephone Number	:	575-541-5030
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 E MADRID AVE STE 8
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-1671
Country	:	US
Telephone Number	:	575-541-5030
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE/OWNER
Name	:	DR. KENNETH EDWARD COOPER JR.
Credential	:	PHARM.D.
Telephone Number	:	575-541-5030

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	03/02/2015

Similar Medicare Providers

1164424578 — JANG SUK MUN M.D.
Practice Location Address:

6875 W CHARLESTON BLVD , SUITE A
LAS VEGAS, NV
89117-1671

Practice Phone: 702-304-2144
Practice Fax: 702-304-2147

1043547052 — MS. MARYJANE A HENNING MS, LMFT, LADC, NCC
Practice Location Address:

6875 W CHARLESTON BLVD , SUITE A
LAS VEGAS, NV
89117-1671

Practice Phone: 702-339-1165
Practice Fax: 702-685-0549

1114234788 — CHRISLYN LEE EBLACAS CPC INTERN
Practice Location Address:

6875 W CHARLESTON BLVD STE A
LAS VEGAS, NV
89117-1671

Practice Phone: 702-545-0229
Practice Fax:

1013514165 — GRATEFUL GUIDANCE CENTER
Practice Location Address:

1838 GIANT ROCK PL
NORTH LAS VEGAS, NV
89031-1671

Practice Phone: 702-677-7410
Practice Fax:

1386490399 — STEVEN GRUNEWALD
Practice Location Address:

1701 N JONES BLVD
LAS VEGAS, NV
89108-1671

Practice Phone: 702-357-8317
Practice Fax: 702-357-8317

1053146357 — CURTIS WITHERSPOON
Practice Location Address:

1701 N JONES BLVD
LAS VEGAS, NV
89108-1671

Practice Phone: 725-290-4878
Practice Fax:

Directions to “LAS CRUCES APOTHECARY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.