Legends Pharmacy III Services LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH00001438 Issued in NM

Legal business name

LEGENDS PHARMACY III SERVICES LLC

Doing business as

Albuquerque Pharmacy
Legends Pharmacy III

Practice address

500 Louisiana Blvd NE
Albuquerque, NM 87108-2051

Phone

(505) 262-5728

Fax

(505) 262-5779

NPI assigned

Jan 9, 2007

Last updated

Aug 30, 2024By 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

Dr. Angela Persyn, PHARMDNPI 1407845977

Title

VP of Pharmacy Operations

Phone

(210) 510-2692

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• ALBUQUERQUE PHARMACY Doing business as
• Legends Pharmacy III Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Albuquerque Pharmacy2 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.

• Legends Pharmacy III Services LLC

  dba Legends Pharmacy III

  • Long Term Care Pharmacy
  • San Antonio, TX
  • NPI 1376300368
  NPD tax ID

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• MM Ops Albuquerque LLC

  dba Manzano Del Sol by PureHealth

  • Skilled Nursing Facility
  • Albuquerque, NM
  • NPI 1568289171

  Adp of the SNF

  CMS ownership
• DV Ops Denton LLC

  dba Denton Village by PureHealth

  • Skilled Nursing Facility
  • Denton, TX
  • NPI 1407673023

  Adp of the SNF

  CMS ownership

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.

• Angela D Persyn, PHARMD

  • Pharmacist
  • San Antonio, TX
  • NPI 1407845977
  Authorized official Same address or phone

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1982753232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 BLANCO RD",
            "address_2": "SUITE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166102",
            "telephone_number": "210-510-2692",
            "fax_number": "210-736-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082051",
            "telephone_number": "505-262-5728",
            "fax_number": "505-262-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDS PHARMACY III SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "PERSYN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "VP OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "210-510-2692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NM",
            "license": "PH00001438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65698",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058119",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALBUQUERQUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ALBUQUERQUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Legends Pharmacy III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Legacy Healthcare, Inc
• Legacy Healthcare, Inc.
• Legacy Medical Specialist LLC
• Paul Morris Legant, M.D.
• Stephen Mark Legate, D.C.
• Johanne M Leger, LPPC
• Loretta N Leger, RPH
• Michel Leger, LPCC
• John A Leggott, MD
• Hadassa Legrand, FNP

• Long Term Care Pharmacy in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Long Term Care Pharmacy in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.