Organization
OLIVE TREE PHARMACY, CO.
Active
Organization
OLIVE TREE PHARMACY, CO.
Active
Other names
Olive Tree Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NDIDIAMAKA OKPAREKE PHARMD (PRESIDENT AND OWNER)
(706) 509-1012
Entity
Organization
Contact information
Practice address
1920 WESTSIDE BLVD SE STE B, RIO RANCHO, NM 87124-4893
(505) 738-3328
Mailing address
1920 WESTSIDE BLVD SE STE B, RIO RANCHO, NM 87124-4893
(505) 738-3328
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
PH00004369
NM
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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