NPIMap

Organization Active NPI

Tony Pesavento

  • Community/Retail Pharmacy
  • Springer, NM
National Provider Identifier
1043393077
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH00003052 Issued in NM
Legal business name
TONY PESAVENTO
Practice address
825 4TH Street
Springer, NM 87747
Phone
(575) 483-2356
Fax
(575) 483-2225
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tony Pesavento, RPH
Title
Owner
Phone
(575) 483-2356

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH00003052 NM Primary

Addresses

Primary practice location

825 4TH Street
Springer, NM 87747

Mailing address

PO Box 427
Springer, NM 87747-0427
Phone (575) 483-2356

Other identifiers 1

IdentifierTypeStateIssuer
3203748OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • SPRINGER DRUG Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1043393077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "SPRINGER",
            "state": "NM",
            "postal_code": "877470427",
            "telephone_number": "575-483-2356",
            "fax_number": "575-483-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 4TH STREET",
            "city": "SPRINGER",
            "state": "NM",
            "postal_code": "87747",
            "telephone_number": "575-483-2356",
            "fax_number": "575-483-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY PESAVENTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "PESAVENTO",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-483-2356",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00003052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3203748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPRINGER DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springer, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.