Organization
ALAMOSA PHARMACY INC
Active
Other names
ALAMOSA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
POLITO MARTINEZ RPH (CO OWNER)
(719) 589-1766
Entity
Organization
Contact information
Practice address
108 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-1766
(719) 589-3960
Mailing address
108 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-1766
(719) 589-3960
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
20000002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003340
—
CO
01
—
0614227
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
11/01/2010
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