Organization
RALEYS OF NEW MEXICO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLINT PENDERGRAFT PHARMD (VP PHARMACY AND HLI)
(916) 373-6146
Entity
Organization
Contact information
Practice address
2910 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-1828
(505) 299-8600
(505) 299-8609
Mailing address
2910 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87112-1828
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH00002743
NM
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3211050
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/30/2006
Last updated
09/11/2025
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