Abq Bestcare Pharmacy 2 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH00004053 Issued in NM

Legal business name

ABQ BESTCARE PHARMACY 2 LLC

Doing business as

Abq Bestcare Pharmacy 2 LLC

Practice address

5400 Gibson Blvd SE
(Gibson Medical Center Pharmacy)
Albuquerque, NM 87108-4729

Phone

(505) 268-2030

Fax

(505) 268-2022

NPI assigned

Sep 28, 2015

Last updated

Mar 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ranjitha Pallapothu

Title

Managing Member

Phone

(214) 675-2012

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• ABQ BESTCARE PHARMACY 2 LLC Doing business as

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1760852271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE",
            "address_2": "(GIBSON MEDICAL CENTER PHARMACY)",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084729",
            "telephone_number": "505-268-2030",
            "fax_number": "505-268-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE",
            "address_2": "(GIBSON MEDICAL CENTER PHARMACY)",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871084729",
            "telephone_number": "505-268-2030",
            "fax_number": "505-268-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABQ BESTCARE PHARMACY 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "PALLAPOTHU",
        "authorized_official_first_name": "RANJITHA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-675-2012"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00004053",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154324",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74501852",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABQ BESTCARE PHARMACY 2 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community/Retail Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.