Organization
LOVELACE HEALTH SYSTEMS INC
Active
Parent organization
LOVELACE HEALTH SYSTEM
Other names
LOVELACE RIO BRAVO PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOVELACE HEALTH SYSTEM
Authorized official
BRAD TROM RPH (CEO)
(505) 727-1299
Entity
Organization
Contact information
Practice address
200 RIO BRAVO BLVD SE, ALBUQUERQUE, NM 87105-5904
(505) 727-5935
(505) 727-9067
Mailing address
PO BOX 27803, ATTN: PHARMACY FINANCE, ALBUQUERQUE, NM 87125-7803
(505) 262-7861
(505) 262-7592
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00001688
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2057696
PK
—
05
—
64121
—
NM
Enumeration date
10/25/2006
Last updated
03/19/2014
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