Healthcare Provider Details

I. General information

NPI: 1114782026
Provider Name (Legal Business Name): BESTCARE HIGHLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 ENCINO PL NE STE 1
ALBUQUERQUE NM
87102-2621
US

IV. Provider business mailing address

717 ENCINO PL NE STE 1
ALBUQUERQUE NM
87102-2621
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-3777
  • Fax: 505-212-0888
Mailing address:
  • Phone: 505-243-3777
  • Fax: 505-212-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ASHOK POTHULA
Title or Position: OWNER
Credential: RPH
Phone: 505-268-2030