Organization
PHC- LOS ALAMOS INC
Active
Other names
LOS ALAMOS MEDICAL CENTER OUTPATIENT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE CROMER PHARM.D. (DIRECTOR OF PHARMACY)
(505) 661-9568
Entity
Organization
Contact information
Practice address
3917 WEST RD, LOS ALAMOS, NM 87544-2275
(505) 661-9560
(505) 661-9599
Mailing address
3917 WEST RD, SUITE 105; OUTPATIENT PHARMACY, LOS ALAMOS, NM 87544-2275
(505) 661-9560
(505) 661-9599
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PH00002421
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02504375
—
NM
01
—
3202859
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/12/2007
Last updated
09/03/2010
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