Organization
ADDISON DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT M ADDISON RPH (OWNER)
(505) 355-2211
Entity
Organization
Contact information
Practice address
323 SUMNER AVE, FORT SUMNER, NM 88119-0550
(505) 355-2211
(505) 355-7816
Mailing address
PO BOX 550, 127 E. SUMNER AVENUE, FORT SUMNER, NM 88119-0550
(505) 355-2211
(505) 355-7816
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00001147
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3202253
NCPDP NUMBER
NM
05
—
56390
—
NM
Enumeration date
07/18/2006
Last updated
08/22/2020
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