Organization
LA FAMILIA MEDICAL CENTER
Active
Other names
La Familia Health Pharmacy, La Familia Medical Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON VANESSA VAN PELT (CEO)
(505) 424-5683
Entity
Organization
Contact information
Practice address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 479-3800
(505) 666-0470
Mailing address
1035 ALTO ST, SANTA FE, NM 87501-2406
(505) 982-4425
(505) 666-0470
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90806565
—
NM
Enumeration date
09/21/2015
Last updated
01/13/2025
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