Organization
VILLAGE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED VICTOR BACA (PHARMACIST)
(505) 356-8555
Entity
Organization
Contact information
Practice address
1719 S AVENUE D, PORTALES, NM 88130-7241
(505) 356-8555
(505) 356-5659
Mailing address
1719 S. AVE D, PORTALES, NM 88130
(505) 356-8555
(505) 356-5659
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
03/10/2015
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