Healthcare Provider Details

I. General information

NPI: 1336296805
Provider Name (Legal Business Name): MAY PHARMACY ISLETA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BRIDGE BLVD SW
ALBUQUERQUE NM
87105-3765
US

IV. Provider business mailing address

6300 SAN MATEO BLVD NE 4C
ALBUQUERQUE NM
87109-3553
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-2377
  • Fax: 505-255-6656
Mailing address:
  • Phone: 505-828-2348
  • Fax: 505-828-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH00003050
License Number StateNM

VIII. Authorized Official

Name: ALLAN YEH
Title or Position: OWNER
Credential: RPH
Phone: 805-255-6111