Organization
OLIVE TREE WELLNESS LLC
Active
Organization
OLIVE TREE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NDIDIAMAKA OKPAREKE (OWNER)
(505) 738-3328
Entity
Organization
Contact information
Practice address
1713 WELLSPRING AVE SE, RIO RANCHO, NM 87124-5106
(505) 738-3328
Mailing address
1713 WELLSPRING AVE SE, RIO RANCHO, NM 87124-5106
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
07/16/2024
Last updated
05/30/2025
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