Organization
KIVA PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM K. WHITE RPH. (CHIEF PHARMACIST)
(505) 982-9550
Entity
Organization
Contact information
Practice address
159 PASEO DE PERALTA, SANTA FE, NM 87501-1857
(505) 982-9550
(505) 982-1576
Mailing address
159 PASEO DE PERALTA, SANTA FE, NM 87501-1857
(505) 982-9550
(505) 982-1576
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH00001731
NM
Other
Enumeration date
04/03/2007
Last updated
12/18/2009
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