Raley'S of New Mexico, Inc.
Organization Active NPI Pharmacy · Toas, NM
NPI 1841392073 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1841392073
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PH00002361 (NM)
- Legal business name
- RALEY'S OF NEW MEXICO, INC.
- Practice address
- 1100 Paseo del Pueblo Sur
Toas, NM 87571 - Phone
- (505) 758-1203
- NPI assigned
- Sep 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Patti Glunz
- Title
- Pharmacy Assistant/Technician
- Phone
- (916) 376-6983
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Raleys of New Mexico Inc
Locations
1100 Paseo del Pueblo Sur
Toas, NM 87571
Phone (505) 758-1203
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PH00002361 | NM | Yes |
Addresses
Primary practice location
1100 Paseo del Pueblo Sur
Toas, NM 87571
Mailing address
500 W Capitol Ave
West Sacramento, CA 95605-2624
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH00002361 | Other | NM | PHARMACY LICENSE |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.