NPIMap

Organization Active NPI

Lovelace Health Systems Inc

  • Specialty Pharmacy
  • Albuquerque, NM
National Provider Identifier
1962646265
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
PH00003167 Issued in NM
Legal business name
LOVELACE HEALTH SYSTEMS INC
Practice address
500 Walter St NE
Suite 202B
Albuquerque, NM 87102-2534
Phone
(505) 727-1299
Fax
(505) 727-2990
NPI assigned
Apr 30, 2009
Reactivated
Nov 22, 2011
Organization subpart
Yes
Parent organization
LOVELACE HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Brad Trom, RPH
Title
Ceo
Phone
(505) 727-1299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X PH00003167 NM Primary

Addresses

Primary practice location

500 Walter St NE
Suite 202B
Albuquerque, NM 87102-2534

Mailing address

PO Box 27803
Pharmacy Finance
Albuquerque, NM 87125-7803
Phone (505) 727-1273

Other identifiers 2

IdentifierTypeStateIssuer
371068MedicaidNM
2120305OtherPK

Other names 1

  • LOVELACE SPECIALTY PHARMACY Doing business as

National Provider Directory

National Provider Directory
Part of
Lovelace Westside Hospital

Locations

500 Walter St NE
Ste 202B
Albuquerque, NM 87102
Phone (505) 727-1299

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1962646265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27803",
            "address_2": "PHARMACY FINANCE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871257803",
            "telephone_number": "505-727-1273",
            "fax_number": "505-727-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "address_2": "SUITE 202B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022534",
            "telephone_number": "505-727-1299",
            "fax_number": "505-727-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE HEALTH SYSTEMS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOVELACE HEALTH SYSTEM",
        "enumeration_date": "2009-04-30",
        "last_updated": "2014-03-19",
        "deactivation_date": "2011-11-09",
        "reactivation_date": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "TROM",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-727-1299",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NM",
            "license": "PH00003167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371068",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOVELACE SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.