Crystal Pharmacy – Community/Retail Pharmacy

Key facts

NPI: 1710765821
Entity type: Organization (NPI type 2)
Primary specialty: Community/Retail Pharmacy 3336C0003X
Legal business name: CRYSTAL PHARMACY
Practice address: 174 Hospital Dr
Raton, NM 87740-2002
Phone: (505) 363-3434
Fax: (575) 445-4899
NPI assigned: Sep 19, 2023
Organization subpart: No

Authorized official

Name: Charles Emmanuel Barkley, RPH
Title: Pharmacist in Charge
Phone: (575) 395-7559

Practitioners 1

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

Charles Emmanuel Barkley, RPH Pharmacist · Raton, NM · NPI 1689784407

NPD

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NM

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20241020000037	NM	Part B Supplier - Pharmacy	5395277008	Practice locations: Raton, NM

National Provider Directory

Locations

174 Hospital Dr
Raton, NM 87740
Phone (505) 426-3838

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacy	333600000X
Community/Retail Pharmacy	3336C0003X			Yes

Addresses

Primary practice location

174 Hospital Dr
Raton, NM 87740-2002

Mailing address

174 Hospital Dr
Raton, NM 87740-2002
Phone (575) 395-7559

Other names

CRYSTAL PHARMACY Doing business as

Other providers in Raton, NM

All providers in Raton, NM · Community/Retail Pharmacy in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.