Healthcare Provider Details

I. General information

NPI: 1588972640
Provider Name (Legal Business Name): NAMBE PHARMACARE SF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 OLD SANTA FE TRL
SANTA FE NM
87505-0306
US

IV. Provider business mailing address

501 OLD SANTA FE TRL
SANTA FE NM
87505-0306
US

V. Phone/Fax

Practice location:
  • Phone: 505-455-2256
  • Fax: 505-455-7929
Mailing address:
  • Phone: 505-455-2256
  • Fax: 505-455-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BYRON SCOTT ROBINSON
Title or Position: OWNER
Credential: PHARMD
Phone: 435-421-1685