# RALEYS OF NEW MEXICO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518062926
- **Authorized official:** FLINT PENDERGRAFT PHARMD (VP PHARMACY AND HLI)
- **Authorized official phone:** (916) 373-6146

## Contact information

- **Practice address:** 8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303
- **Practice address phone:** (505) 822-8484
- **Mailing address:** 8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | PH00002797 | NM | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3211202 | NCPDP | NM |