Healthcare Provider Details
I. General information
NPI: 1013946755
Provider Name (Legal Business Name): FAMILY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/03/2006
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1205 S SOLANO DR
LAS CRUCES NM
88001-3755
US
IV. Provider business mailing address
1205 S SOLANO DR
LAS CRUCES NM
88001-3755
US
V. Phone/Fax
- Phone: 575-526-1599
- Fax: 575-524-3528
- Phone: 575-526-1599
- Fax: 575-524-3528
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH-2306 |
| License Number State | NM |
VIII. Authorized Official
Name: MR.
ROBERT
FRANCIS
ADAMS
Title or Position: PHARMACIST/OWNER
Credential: RPH.
Phone: 575-526-1599