Organization
PRESBYTERIAN HEALTHCARE SERVICES
Active
Parent organization
PLAINS REGIONAL MEDICAL CENTER PHARMACY
Other names
Plains Regional Medical Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
PLAINS REGIONAL MEDICAL CENTER PHARMACY
Authorized official
KIMBERLY POLAND (PROVIDER ENROLLMENT MANAGER)
(505) 923-5355
Entity
Organization
Contact information
Practice address
2401 W. 21ST ST, CLOVIS, NM 88101
(575) 769-7680
(575) 769-7156
Mailing address
2401 W. 21ST ST, CLOVIS, NM 88101
(575) 769-7541
(575) 769-7156
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH00003710
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47438363
—
NM
Enumeration date
06/23/2014
Last updated
07/21/2022
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