Guadalupe County

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH00003554 Issued in NM

Legal business name

GUADALUPE COUNTY

Doing business as

Route 66 Pharmacy

Practice address

117 Camino de Vida Ste 200
Santa Rosa, NM 88435-2267

Phone

(575) 472-5666

Fax

(575) 472-9666

NPI assigned

Feb 21, 2007

Last updated

Sep 12, 2023By 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

Christina Campos, MBA

Title

Administrator

Phone

(575) 472-5666

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Route 66 Pharmacy Doing business as

Tax ID family

Guadalupe County Hospit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Guadalupe County

  dba Guadalupe County Ambulance Service

  • Land Ambulance
  • Santa Rosa, NM
  • NPI 1063227494
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Cruz Arenas, PHARM.D.

  • Pharmacist
  • Santa Rosa, NM
  • NPI 1568005262
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1982749453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CAMINO DE VIDA STE 200",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352267",
            "telephone_number": "575-472-5666",
            "fax_number": "575-472-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CAMINO DE VIDA STE 200",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352267",
            "telephone_number": "575-472-5666",
            "fax_number": "575-472-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "575-472-5666",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00003554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141912",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88484009",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Route 66 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greater Santa Rosa Council on Alcoholism (Professional Counseling Associ)
• Greater Santa Rosa Council on Alcoholism (Professional Counseling Associates New Mexico)
• Mark Land Grossetete, M.D., PH.D.
• Guadalupe County (Guadalupe County Ambulance Service)
• Guadalupe County (Guadalupe County Hospital)
• Christopher Gutierrez, BMS
• Miranda C Haley, M.D.
• Yolanda M Hern, LISW
• Ann Marie Higgins
• Cassidy Ruth Huffman

• Community/Retail Pharmacy in Santa Rosa, NM
• Providers in Santa Rosa, 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 Sep 12, 2023; 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.