Healthcare Provider Details

I. General information

NPI: 1568545051
Provider Name (Legal Business Name): K-DRUGS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 W. HWY. 550 PHARMACY PLUS
BERNALILLO NM
87004-5995
US

IV. Provider business mailing address

407 W. HWY. 550 PHARMACY PLUS
BERNALILLO NM
87004-5995
US

V. Phone/Fax

Practice location:
  • Phone: 505-867-2336
  • Fax: 505-867-0911
Mailing address:
  • Phone: 505-867-2336
  • Fax: 505-867-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH00001754
License Number StateNM

VIII. Authorized Official

Name: MR. GEORGE ALLEN SANDOVAL
Title or Position: OWNER
Credential: RPH
Phone: 505-345-3568