Dillard B Irby

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH00001186 Issued in NM

Legal business name

DILLARD B IRBY

Doing business as

Professional Pharmacy

Practice address

275 Central Ave # a
Tularosa, NM 88352-2009

Phone

(575) 585-2772

Fax

(575) 585-2777

NPI assigned

Jan 30, 2007

Last updated

Apr 12, 2011By 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

Dillard Irby, RPH

Title

Pharmacist and Owner

Phone

(575) 585-2772

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PROFESSIONAL PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1902942519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CENTRAL AVE # A",
            "city": "TULAROSA",
            "state": "NM",
            "postal_code": "883522009",
            "telephone_number": "575-585-2772",
            "fax_number": "575-585-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CENTRAL AVE # A",
            "city": "TULAROSA",
            "state": "NM",
            "postal_code": "883522009",
            "telephone_number": "575-585-2772",
            "fax_number": "575-585-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLARD B IRBY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "IRBY",
        "authorized_official_first_name": "DILLARD",
        "authorized_official_title_or_position": "PHARMACIST AND OWNER",
        "authorized_official_telephone_number": "575-585-2772",
        "authorized_official_credential": "RPH"
    },
    "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": "PH00001186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63255",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3207758",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Dawn Antonio, A.A.
• Annette Susan Buck, LPTA
• Octavia Rogers Clampet, LCSW
• Martin A Cook Sr., LMSW
• Jackie Cope, LMSW
• Rhiannon Eisler
• Margaret Suzanne Fowler, PHD
• Christiane George, D.O.
• April Renee Gonzales
• Jody Lea Hill

• Community/Retail Pharmacy in Tularosa, NM
• Providers in Tularosa, 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 Apr 12, 2011; 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.