Organization
DILLARD B IRBY
Active
Other names
PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DILLARD IRBY RPH (PHARMACIST AND OWNER)
(575) 585-2772
Entity
Organization
Contact information
Practice address
275 CENTRAL AVE # A, TULAROSA, NM 88352-2009
(575) 585-2772
(575) 585-2777
Mailing address
275 CENTRAL AVE # A, TULAROSA, NM 88352-2009
(575) 585-2772
(575) 585-2777
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH00001186
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3207758
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
63255
—
NM
Enumeration date
01/30/2007
Last updated
04/12/2011
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