Organization
DURAN CENTRAL PHARMACY, INC.
Active
Other names
Duran Central Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MONA GHATTAS (PRESIDENT, AO)
(505) 247-4141
Entity
Organization
Contact information
Practice address
1815 CENTRAL AVE NW, ALBUQUERQUE, NM 87104-1143
(505) 247-4141
(505) 843-6249
Mailing address
1815 CENTRAL AVE NW, ALBUQUERQUE, NM 87104-1143
(505) 247-4141
(505) 843-6249
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH3087
NM
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125193
PK
—
05
—
55669
—
NM
05
—
55699
—
NM
Enumeration date
11/09/2006
Last updated
01/11/2021
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