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General NPI Number Information
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NPI Number | 1437233574
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Entity Type | Organization
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Legal Business Name | LOVELACE HEALTH SYSTEMS INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 5150 JOURNAL CENTER BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5900
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Country | US
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Telephone | 505-727-5920
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Fax | 505-727-9501
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Provider Business Mailing Address
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Address Line | PO BOX 27803 ATTN: PHARMACY FINANCE
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-7803
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Country | US
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Telephone | 505-262-7861
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Fax | 505-262-7592
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Authorized Official
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Title or Position | CEO
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Name | BRAD TROM
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Credential | R.PH
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Telephone | 505-727-1299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH00001684
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License Number State | NM
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