Active NPI
MJRX V, LLC
- Long Term Care Pharmacy
- Carlsbad, NM
National Provider Identifier
1437170404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- PH00002988
- Legal business name
- MJRX V, LLC
- Practice address
- 2402 W Pierce St
Ste 2B
Carlsbad, NM 88220-3537 - Phone
- (575) 885-2979
- Fax
- (575) 885-2979
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen J Kocherhans
- Title
- Owner/Ceo
- Phone
- (505) 881-4601
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X | PH00002988 | NM | Primary |
Addresses
Primary practice location
2402 W Pierce St
Ste 2B
Carlsbad, NM 88220-3537
Mailing address
7209 Jefferson St NE
Albuquerque, NM 87109-4307
Phone (505) 881-4601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55533 | Medicaid | NM |
Other names 1
- ADVANCED MEDICATION MANAGEMENT SYSTEMS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000998 | NM | Part B Supplier - Mass Immunization (Roster Biller Only) | 4284529843 | Practice locations: Carlsbad, NM |
| O20220119001826 | NM | Part B Supplier - Pharmacy | 4880086123 | Practice locations: Carlsbad, NM |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D2258738 | Advanced Medication Management Systems | Certificate of waiver | Apr 25, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Carlsbad, NM
- NPI 1639178338
-
- Pharmacist
- Carlsbad, NM
- NPI 1265835284
-
- Pharmacist
- Carlsbad, NM
- NPI 1003801572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1637280000000",
"number": "1437170404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7209 JEFFERSON ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871094307",
"telephone_number": "505-881-4601",
"fax_number": "505-881-4647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2402 W PIERCE ST",
"address_2": "STE 2B",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882203537",
"telephone_number": "575-885-2979",
"fax_number": "575-885-2979"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MJRX V, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-22",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A",
"authorized_official_last_name": "KOCHERHANS",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "505-881-4601"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "NM",
"license": "PH00002988",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55533",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ADVANCED MEDICATION MANAGEMENT SYSTEMS",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ADVANCED MEDICATION MANAGEMENT SYSTEMS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Carlsbad, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.