Corrales Pharmacy Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

Legal business name

CORRALES PHARMACY INC

Doing business as

Placitas Pharmacy

Practice address

221 State Highway 165 # A4
A4
Placitas, NM 87043-9514

Phone

(505) 480-6327

NPI assigned

Feb 10, 2020

Last updated

Feb 10, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

CORRALES PHARMACYAs reported in NPPES

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

Authorized official

Name

Dr. Mike Lee Gallegos, PHARMD, PC

Title

Pic Owner

Phone

(505) 480-6327

Specialties & licenses 1

Addresses

Other names 1

• PLACITAS PHARMACY Doing business as

Part of

Corrales Pharmacy Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail Anne Walsh, PHARMD

  • Pharmacist
  • Corrales, NM
  • NPI 1205481785
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1386276160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 STATE HIGHWAY 165 # A4",
            "address_2": "A4",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439514",
            "telephone_number": "505-480-6327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 STATE HIGHWAY 165 # A4",
            "address_2": "A4",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439514",
            "telephone_number": "505-480-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRALES PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORRALES PHARMACY",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PIC OWNER",
        "authorized_official_telephone_number": "505-480-6327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, PC"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLACITAS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matt Roy Burton
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• Mary M Cline, MA, LPCC
• Daniel Cordova, OTRL
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• Jeffrey Alan Franken, LMHC
• Irene Gale, RPH

• Clinic Pharmacy in Placitas, NM
• Providers in Placitas, NM by specialty
• Clinic Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.