Organization
TONY PESAVENTO
Active
Other names
SPRINGER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
TONY PESAVENTO RPH (OWNER)
(575) 483-2356
Entity
Organization
Contact information
Practice address
825 4TH STREET, SPRINGER, NM 87747
(575) 483-2356
(575) 483-2225
Mailing address
PO BOX 427, SPRINGER, NM 87747-0427
(575) 483-2356
(575) 483-2225
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH00003052
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3203748
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/23/2006
Last updated
01/09/2013
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