Organization
MJRX IV, LLC
Active
Organization
MJRX IV, LLC
Active
Other names
Southwest Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J KOCHERHANS (OWNE/CEO)
(505) 881-4601
Entity
Organization
Contact information
Practice address
2402 W PIERCE ST STE 1A, CARLSBAD, NM 88220-3568
(575) 887-6611
(575) 557-0782
Mailing address
7209 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4307
(505) 881-4601
(505) 881-4647
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH00002987
NM
3336C0003X
Community/Retail Pharmacy
Primary
PH00002987
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63016
—
NM
Enumeration date
07/11/2006
Last updated
11/19/2021
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