Organization
RIOGRANDE CARE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAM MOHAN VENEPALLY MD (HOSPITALIST)
(917) 509-0377
Entity
Organization
Contact information
Practice address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 323-3938
(575) 652-3393
Mailing address
4371 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 323-3938
(575) 652-3393
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00005014
STATE BOARD OF PHARMACY
NM
Enumeration date
06/16/2020
Last updated
06/16/2020
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