Healthcare Provider Details

I. General information

NPI: 1477642163
Provider Name (Legal Business Name): IRON HORSE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 MAIN ST
LORDSBURG NM
88045-1910
US

IV. Provider business mailing address

311 MAIN ST
LORDSBURG NM
88045-1910
US

V. Phone/Fax

Practice location:
  • Phone: 505-542-9142
  • Fax: 505-542-9869
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH00001247
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: W CHRIS SANDERS
Title or Position: OWNER
Credential: RPH
Phone: 505-521-1182