Organization
CIBOLA GENERAL HOSPITAL PHCY
Active
Other names
Cibola General Hospital Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW HALL RPH (DIRECTOR OF PHARMACY)
(505) 287-5320
Entity
Organization
Contact information
Practice address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-5320
(505) 287-5325
Mailing address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-5320
(505) 287-5325
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PH00002150
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00729
—
NM
01
—
3204625
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/05/2010
Last updated
10/05/2010
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