Phil Parkhurst, R.PH.
Individual provider Active NPI Pharmacist · Grants, NM
NPI 1154487635 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1154487635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 3174 (NM)
- Practice address
- 1208 Bonita St
Grants, NM 87020-2234 - Phone
- (505) 287-4641
- Fax
- (505) 287-7160
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3174 | NM | Yes |
Addresses
Primary practice location
1208 Bonita St
Grants, NM 87020-2234
Mailing address
1208 Bonita St
Grants, NM 87020-2234
Phone (505) 287-4641
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55103 | Medicaid | NM | |
| T3340 | Medicaid | NM | |
| 3202366 | Other | NCPDP |
Other providers in Grants, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.