NPIMap

Organization Active NPI

Vida Pharmacy LLC

  • Long Term Care Pharmacy
  • Albuquerque, NM
National Provider Identifier
1609056035
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH00002980 Issued in NM
Legal business name
VIDA PHARMACY LLC
Doing business as
VIDA PHARMACY LLC
Practice address
8500 Jefferson St NE
Ste D
Albuquerque, NM 87113-1883
Phone
(505) 856-1660
Fax
(505) 856-7141
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Authorized official

Name
Annabel Roberts, PHARMDNPI 1811592009
Title
Owner
Phone
(505) 856-1660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X PH00002980 NM Primary

Addresses

Primary practice location

8500 Jefferson St NE
Ste D
Albuquerque, NM 87113-1883

Mailing address

8500 Jefferson St NE
Ste D
Albuquerque, NM 87113-1883
Phone (505) 856-1660

Other identifiers 1

IdentifierTypeStateIssuer
2059025OtherPK

Other names 1

  • VIDA PHARMACY LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1609056035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 JEFFERSON ST NE",
            "address_2": "STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131883",
            "telephone_number": "505-856-1660",
            "fax_number": "505-856-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 JEFFERSON ST NE",
            "address_2": "STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131883",
            "telephone_number": "505-856-1660",
            "fax_number": "505-856-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ANNABEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-856-1660",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NM",
            "license": "PH00002980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2059025",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIDA PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.