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General NPI Number Information
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NPI Number | 1720806847
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Entity Type | Organization
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Legal Business Name | FARMINGTON FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 622 W MAPLE ST STE D
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City | FARMINGTON
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State | NM
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Zip | 87401-6589
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Country | US
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Telephone | 505-566-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 622 W MAPLE ST STE D
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City | FARMINGTON
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State | NM
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Zip | 87401-6589
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Country | US
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Telephone | 505-566-5105
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | CLETE NORMAN FINCH JR.
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Credential | PHARMD
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Telephone | 505-566-5105
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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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