Healthcare Provider Details

I. General information

NPI: 1790790327
Provider Name (Legal Business Name): SHARE N CARE PHARMACY AND MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DALIES AVE STE B
BELEN NM
87002-3617
US

IV. Provider business mailing address

701 DALIES AVE STE B
BELEN NM
87002
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 TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPH00002409
License Number StateNM

VIII. Authorized Official

Name: WILFRED CHAVEZ
Title or Position: OWNER AND PARTNER
Credential: RPH
Phone: 505-864-7491