PHC- Los Alamos Inc
Organization Active NPI Clinic Pharmacy · Los Alamos, NM
NPI 1821130626 · NPPES record last updated Sep 3, 2010
Key facts
- NPI
- 1821130626
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic Pharmacy 3336C0002X
- License
- PH00002421 (NM)
- Legal business name
- PHC- LOS ALAMOS INC
- Practice address
- 3917 West Rd
Los Alamos, NM 87544-2275 - Phone
- (505) 661-9560
- Fax
- (505) 661-9599
- NPI assigned
- Feb 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Bruce Cromer, PHARM.D.
- Title
- Director of Pharmacy
- Phone
- (505) 661-9568
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- PHC-Los Alamos Inc
Locations
3917 West Rd
Ste 105
Los Alamos, NM 87544
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | PH00002421 | NM | Yes |
Addresses
Primary practice location
3917 West Rd
Los Alamos, NM 87544-2275
Mailing address
3917 West Rd
Suite 105; Outpatient Pharmacy
Los Alamos, NM 87544-2275
Phone (505) 661-9560
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02504375 | Medicaid | NM | |
| 3202859 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- LOS ALAMOS MEDICAL CENTER OUTPATIENT PHARMACY
Other providers in Los Alamos, NM
- Roberto C. Pardo
- Sara Pasqualoni
- Anne Elizabeth Peick
- Elisabeth Scherf Perry
- Melissa Jane Petty
- PHC-Los Alamos Inc
- PHC-Los Alamos Inc
- PHC-Los Alamos Inc
- Physical Therapy Plus Inc
- Petra Pirc
All providers in Los Alamos, NM · Clinic 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 Sep 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.