Organization
KMART PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AMBRISH N PATEL PHARMD (PHARMACY MANAGER)
(405) 370-4669
Entity
Organization
Contact information
Practice address
1205 E PINE ST, DEMING, NM 88030-7038
(575) 544-9008
(575) 544-4465
Mailing address
1205 E PINE ST, DEMING, NM 88030-7038
(575) 544-9008
(575) 544-4465
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP00007752
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908753
PHARMACY NPI NUMBER
NM
Enumeration date
05/03/2014
Last updated
05/03/2014
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