Organization
RALEYS OF NEW MEXICO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLINT PENDERGRAFT PHARMD (VP PHARMACY AND HLI)
(916) 373-6146
Entity
Organization
Contact information
Practice address
8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303
(505) 822-8484
Mailing address
8100 VENTURA ST NE, ALBUQUERQUE, NM 87122-1303
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH00002797
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3211202
NCPDP
NM
Enumeration date
09/13/2006
Last updated
08/22/2020
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