Kelley Pharmacy

LBN: Kelley Pharmacy
Kelley Pharmacy is an health care organization with primary practice located at 111 W Hobbs St , Roswell NM 88203-1869. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Kelley Pharmacy can be contacted via phone (505) 622-6000, or through Baumann, Beau via phone (505) 623-3311.

Contact Information

Primary practice address
111 W Hobbs St Roswell NM 88203-1869
Phone: (505) 622-6000
Fax: (505) 623-8692
Website:
Map and Directions
Authorized official contact:
Name: Baumann, Beau
Phone: (505) 623-3311

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH00001203 New Mexico

Profile Details

NPI number 1629145792
LBN Legal business name Kelley Pharmacy
DBA Doing business as
Authorized official Baumann, Beau
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2006
Last updated Sep 13th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629145792 NPPES
Other 3200540 OTHER ID NUMBER
MEDICAID 56473 OTHER ID NUMBER

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