NPIMap

Organization Active NPI

PHC- Los Alamos Inc

Doing business as Los Alamos Medical Center Outpatient Pharmacy

  • Clinic Pharmacy
  • Los Alamos, NM
National Provider Identifier
1821130626
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PH00002421 Issued in NM
Legal business name
PHC- LOS ALAMOS INC
Doing business as
Los Alamos Medical Center Outpatient Pharmacy
Practice address
3917 West Rd
Los Alamos, NM 87544-2275
Phone
(505) 661-9560
Fax
(505) 661-9599
NPI assigned
Feb 12, 2007
Last updated
Sep 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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

Authorized official

Name
Bruce Cromer, PHARM.D.
Title
Director of Pharmacy
Phone
(505) 661-9568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PH00002421 NM Primary

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 names 1

  • LOS ALAMOS MEDICAL CENTER OUTPATIENT PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PHC Los Alamos Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

3917 West Rd
Ste 105
Los Alamos, NM 87544

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1821130626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "address_2": "SUITE 105; OUTPATIENT PHARMACY",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-9560",
            "fax_number": "505-661-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-9560",
            "fax_number": "505-661-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC- LOS ALAMOS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "CROMER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "505-661-9568",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NM",
            "license": "PH00002421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOS ALAMOS MEDICAL CENTER OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.