NPIMap

Organization Active NPI

Michael'S Prescription Corner

  • Community/Retail Pharmacy
  • Lovington, NM
National Provider Identifier
1649311374
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CS00208480 Issued in NM
Legal business name
MICHAEL'S PRESCRIPTION CORNER
Practice address
123 W Avenue a
Lovington, NM 88260-4211
Phone
(575) 396-2311
Fax
(575) 396-2321
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Michael RaburnNPI 1629882261
Title
Owner
Phone
(505) 396-2311

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
Community/Retail Pharmacy 3336C0003X CS00208480 NM Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

123 W Avenue a
Lovington, NM 88260-4211

Mailing address

123 W Avenue a
Lovington, NM 88260-4211
Phone (575) 396-2311

Other identifiers 2

IdentifierTypeStateIssuer
3202873OtherNCPDP PROVIDER IDENTIFICATION NUMBER
55061MedicaidNM

Other names 1

  • MICHAEL'S PRESCRIPTION CORNER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Michael'S Prescription Corner4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 W Avenue A
Lovington, NM 88260
Phone (575) 396-2311

Practitioners & affiliated clinicians

Practitioners 1

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1649311374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W AVENUE A",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882604211",
            "telephone_number": "575-396-2311",
            "fax_number": "575-396-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W AVENUE A",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882604211",
            "telephone_number": "575-396-2311",
            "fax_number": "575-396-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL'S PRESCRIPTION CORNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "RABURN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-396-2311"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "CS00208480",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3202873",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55061",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHAEL'S PRESCRIPTION CORNER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MICHAEL'S PRESCRIPTION CORNER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lovington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.