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Organization
RALEYS OF NEW MEXICO INC
Active
Organization
RALEYS OF NEW MEXICO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLINT PENDERGRAFT PHARMD (VP PHARMACY AND HLI)
(916) 373-6146
Entity
Organization
Contact information
Practice address
8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303
(505) 822-8484
Mailing address
8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH00002797
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3211202
NCPDP
NM
Enumeration date
09/13/2006
Last updated
08/22/2020
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