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General NPI Number Information
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NPI Number | 1245239185
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Entity Type | Organization
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Legal Business Name | MJRX II LLC
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 1445 WYOMING BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-3849
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Country | US
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Telephone | 505-299-4496
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Fax | 505-299-7713
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Provider Business Mailing Address
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Address Line | 1445 WYOMING BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-3849
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Country | US
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Telephone | 505-299-4496
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Fax | 505-299-7713
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN J KOCHERHANS
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Credential |
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Telephone | 505-299-4496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH00004054
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License Number State | NM
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