Bestcare Pharmacy Grants LLC
Organization Active NPI Pharmacy · Grants, NM
NPI 1861949851 · NPPES record last updated Feb 14, 2017
Key facts
- NPI
- 1861949851
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- PH00004229 (NM)
- Legal business name
- BESTCARE PHARMACY GRANTS LLC
- Practice address
- 1208 Bonita St Ste a
Grants, NM 87020-2234 - Phone
- (505) 287-4641
- Fax
- (505) 287-7160
- NPI assigned
- Sep 7, 2016
- Organization subpart
- No
Authorized official
- Name
- Ranjitha Pallapothu
- Title
- Authorized Official
- Phone
- (214) 675-2012
Member organizations 1
Practitioners 1
-
Matthew Munson, PHARM D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171011003363 | NM | Part B Supplier - Mass Immunization (Roster Biller Only) | 0244516425 | Practice locations: Grants, NM |
National Provider Directory
Locations
1208 Bonita St
Ste A
Grants, NM 87020
Phone (505) 287-4641
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PH00004229 | NM | Yes |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
1208 Bonita St Ste a
Grants, NM 87020-2234
Mailing address
1208 Bonita St Ste a
Grants, NM 87020-2234
Phone (505) 287-4641
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2159707 | Other | PK |
Other names
- Parkhurst Pharmacy
Other providers in Grants, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. 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.