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General NPI Number Information
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NPI Number | 1053510891
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Entity Type | Organization
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Legal Business Name | LOVELACE PHARMACY
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 13701 ENCANTADO RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87123-2275
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Country | US
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Telephone | 505-237-8762
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Fax | 505-237-8701
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Provider Business Mailing Address
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Address Line | 4201 ROMA AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-1133
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Country | US
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Telephone | 505-268-2109
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Fax | 505-237-8701
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. CLAIRE SUZANNE SEELINGER
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Credential | RPH
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Telephone | 505-268-2109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | RP00006057
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License Number State | NM
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