Healthcare Provider Details

I. General information

NPI: 1295618791
Provider Name (Legal Business Name): MESILLA VALLEY PHARMACY & CONSULTING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4119 WHITE SAGE ARC STE F
LAS CRUCES NM
88011-7326
US

IV. Provider business mailing address

4119 WHITE SAGE ARC STE F
LAS CRUCES NM
88011-7352
US

V. Phone/Fax

Practice location:
  • Phone: 575-323-2093
  • Fax:
Mailing address:
  • Phone: 575-323-2093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WAYNE HOWARD
Title or Position: CEO
Credential: PHARMACIST
Phone: 575-323-2093