Organization
ABQ BESTCARE PHARMACY 2 LLC
Active
Other names
ABQ BESTCARE PHARMACY 2 LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RANJITHA PALLAPOTHU (MANAGING MEMBER)
(214) 675-2012
Entity
Organization
Contact information
Practice address
5400 GIBSON BLVD SE, (GIBSON MEDICAL CENTER PHARMACY), ALBUQUERQUE, NM 87108-4729
(505) 268-2030
(505) 268-2022
Mailing address
5400 GIBSON BLVD SE, (GIBSON MEDICAL CENTER PHARMACY), ALBUQUERQUE, NM 87108-4729
(505) 268-2030
(505) 268-2022
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00004053
NM
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154324
PK
—
05
—
74501852
—
NM
Enumeration date
09/28/2015
Last updated
03/21/2016
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