Organization
SILVER REXALL DRUGS INC
Active
Other names
SILVER REXALL DRUG INC
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT MARTINEZ PHRM (PRESIDENT)
(505) 388-1579
Entity
Organization
Contact information
Practice address
1308 SILVER HEIGHTS BLVD, SILVER CITY, NM 88061-5528
(575) 388-1579
(575) 538-0525
Mailing address
1308 SILVER HEIGHTS BLVD, SILVER CITY, NM 88061-5528
(575) 388-1579
(575) 538-0525
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00001400
NM
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3203697
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
58016
—
NM
Enumeration date
11/08/2006
Last updated
02/08/2012
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