Healthcare Provider Details

I. General information

NPI: 1053361048
Provider Name (Legal Business Name): READY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W LISA DR
CHAPARRAL NM
88081-7458
US

IV. Provider business mailing address

111 W LISA DR
CHAPARRAL NM
88081-7458
US

V. Phone/Fax

Practice location:
  • Phone: 575-824-8211
  • Fax: 575-824-8208
Mailing address:
  • Phone: 505-824-8211
  • Fax: 505-824-8208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6446
License Number StateNM

VIII. Authorized Official

Name: MR. ELISEO RAMIREZ
Title or Position: TECHNICIAN
Credential: CPHT
Phone: 505-824-8211