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General NPI Number Information
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NPI Number | 1205251758
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Entity Type | Organization
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Legal Business Name | MICHAEL'S PRESCRIPTION CORNER
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 1024 MAIN
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City | EUNICE
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State | NM
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Zip | 88231
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Country | US
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Telephone | 575-394-2311
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 189
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City | EUNICE
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State | NM
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Zip | 88231-0189
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Country | US
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Telephone | 575-394-2311
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Fax | 575-394-0429
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MICHAEL RABURN
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Credential | RPH
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Telephone | 575-394-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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