Organization
LOVELACE HEALTH SYSTEMS INC
Active
Parent organization
LOVELACE HEALTH SYSTEM
Other names
LOVELACE JUAN TABO PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOVELACE HEALTH SYSTEM
Authorized official
BRAD TROM RPH (CEO)
(505) 727-1299
Entity
Organization
Contact information
Practice address
2121 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-3307
(505) 727-5925
(505) 727-9071
Mailing address
PO BOX 27803, ATTN: PHARMACY FINANCE, ALBUQUERQUE, NM 87125-7803
(505) 262-7681
(505) 262-7592
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00001694
NM
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057208
PK
—
05
—
64139
—
NM
Enumeration date
10/25/2006
Last updated
03/19/2014
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