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NPI Code Detail

MEDICARE: PHC-LAS CRUCES INC. DBA MEMORIAL MEDICAL CENTER INPATIENT PHARMACY

MEDICARE: PHC-LAS CRUCES INC. DBA MEMORIAL MEDICAL CENTER INPATIENT PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336I0012XInstitutional Pharmacy

General Provider Information

NPI Number : 1982555363
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHC-LAS CRUCES INC. DBA MEMORIAL MEDICAL CENTER INPATIENT PHARMACY
Provider Business Mailing Address
First Line : 2450 S TELSHOR BLVD
Second Line : GROUND FLOOR, INPATIENT PHARMACY
City : LAS CRUCES
State : NM
Zip : 88011-5069
Country : US
Telephone Number : 724-554-9566
Fax Number :
Provider Business Practice Location Address
First Line : 2450 S TELSHOR BLVD
Second Line : GROUND FLOOR, INPATIENT PHARMACY
City : LAS CRUCES
State : NM
Zip : 88011-5069
Country : US
Telephone Number : 724-554-9566
Fax Number :
Authorized Official
Title or Position : CPO
Name : DR. ALFRED ADAM L'ALTRELLI
Credential : PHARMD
Telephone Number : 575-521-5541
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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