Healthcare Provider Details
I. General information
NPI: 1275471336
Provider Name (Legal Business Name): DEL-REY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3291 DEL REY BLVD STE 3
LAS CRUCES NM
88012-5045
US
IV. Provider business mailing address
3291 DEL REY BLVD STE 3
LAS CRUCES NM
88012-5045
US
V. Phone/Fax
- Phone: 575-888-4756
- Fax: 575-652-4519
- Phone: 575-888-4756
- Fax: 575-652-4519
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KENNETH
C
OKWUNWANNE
Title or Position: PHARMACIST
Credential:
Phone: 575-888-4756