Organization
LEGENDS PHARMACY III SERVICES LLC
Active
Other names
Legends Pharmacy III, ALBUQUERQUE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA PERSYN PHARMD (VP OF PHARMACY OPERATIONS)
(210) 510-2692
Entity
Organization
Contact information
Practice address
500 LOUISIANA BLVD NE, ALBUQUERQUE, NM 87108-2051
(505) 262-5728
(505) 262-5779
Mailing address
6601 BLANCO RD, SUITE 201, SAN ANTONIO, TX 78216-6102
(210) 510-2692
(210) 736-4438
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH00001438
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058119
PK
—
05
—
65698
—
NM
Enumeration date
01/09/2007
Last updated
08/30/2024
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