Healthcare Provider Details

I. General information

NPI: 1043705890
Provider Name (Legal Business Name): ALBRIGHTON PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 ANTHONY DR STE E
ANTHONY NM
88021
US

IV. Provider business mailing address

401 ANTHONY DR STE E
ANTHONY NM
88021
US

V. Phone/Fax

Practice location:
  • Phone: 575-323-1241
  • Fax:
Mailing address:
  • Phone: 575-323-1241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER SWEET
Title or Position: CEO
Credential:
Phone: 832-374-8630