Organization
STATE OF NEW MEXICO
Active
Other names
New Mexico State Veterans Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE R RICHTER (ADMINISTRATIVE SERVICES DIRECTOR)
(575) 894-4216
Entity
Organization
Contact information
Practice address
992 S BROADWAY, TRUTH OR CONSEQUENCES, NM 87901
(575) 894-4200
(575) 894-4291
Mailing address
992 S BROADWAY, TRUTH OR CONSEQUENCES, NM 87901
(575) 894-4200
(575) 894-4291
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
CS00021264
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3208774
MEDICARE D
NM
05
—
65755
—
NM
Enumeration date
07/14/2006
Last updated
04/18/2017
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