Healthcare Provider Details

I. General information

NPI: 1013216027
Provider Name (Legal Business Name): RX EXPRESS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 MENAUL NE
ALBUQUERQUE NM
87112-8700
US

IV. Provider business mailing address

8900 MENAUL NE
ALBUQUERQUE NM
87112-8700
US

V. Phone/Fax

Practice location:
  • Phone: 505-610-4030
  • Fax:
Mailing address:
  • Phone: 505-610-4030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number StateNM

VIII. Authorized Official

Name: MR. ALLAN YEH
Title or Position: PHARMACIST
Credential: R.PH
Phone: 505-610-4030