NPIMap

Organization Active NPI

Olive Tree Pharmacy, Co.

  • Clinic/Center
  • Rio Rancho, NM
National Provider Identifier
1053850784
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
PH00004369 Issued in NM
Legal business name
OLIVE TREE PHARMACY, CO.
Practice address
1920 Westside Blvd SE Ste B
Rio Rancho, NM 87124-4893
Phone
(505) 738-3328
NPI assigned
Feb 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Ndidiamaka Okpareke, PHARMD
Title
President and Owner
Phone
(706) 509-1012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X PH00004369 NM Primary

Addresses

Primary practice location

1920 Westside Blvd SE Ste B
Rio Rancho, NM 87124-4893

Mailing address

1920 Westside Blvd SE Ste B
Rio Rancho, NM 87124-4893
Phone (505) 738-3328

Other names 1

  • Olive Tree Compounding Pharmacy Other name

National Provider Directory

National Provider Directory

Locations

1920 Westside Blvd SE
Ste B
Rio Rancho, NM 87124
Phone (505) 738-3328

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1053850784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 WESTSIDE BLVD SE STE B",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244893",
            "telephone_number": "505-738-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 WESTSIDE BLVD SE STE B",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244893",
            "telephone_number": "505-738-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE PHARMACY, CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "OKPAREKE",
        "authorized_official_first_name": "NDIDIAMAKA",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "706-509-1012",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "PH00004369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olive Tree Compounding Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.