Healthcare Provider Details

I. General information

NPI: 1831868751
Provider Name (Legal Business Name): NM COMPOUNDING AND INFUSION PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CARMEL AVE NE STE 601
ALBUQUERQUE NM
87122-3125
US

IV. Provider business mailing address

8300 CARMEL AVE NE STE 601
ALBUQUERQUE NM
87122-3125
US

V. Phone/Fax

Practice location:
  • Phone: 505-510-1375
  • Fax: 505-501-7451
Mailing address:
  • Phone: 505-510-1375
  • Fax: 505-501-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SMITH
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 505-510-1375