Healthcare Provider Details

I. General information

NPI: 1154466274
Provider Name (Legal Business Name): SHARE N CARE PHARMACY AND MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DALIES AVE
BELEN NM
87002-3617
US

IV. Provider business mailing address

701 DALIES AVE
BELEN NM
87002-3617
US

V. Phone/Fax

Practice location:
  • Phone: 505-864-7471
  • Fax: 505-864-6535
Mailing address:
  • Phone: 505-864-7471
  • Fax: 505-864-6535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. WILFRED O CHAVEZ
Title or Position: OWNER
Credential: PHARMACIST
Phone: 505-864-7471