KELLEY PHARMACY (NPI# 1629145792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629145792 |
| Entity Type | Organization |
| Organization Name | KELLEY PHARMACY |
| Practice Address |
111 W Hobbs St Roswell NM 88203-1869 |
| Mailing Address |
Po Box 639 Roswell NM 88202-0639 |
| Practice Telephone | 5056226000 |
| Practice Fax Number | 5056238692 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-09-13 |
| Authorized Official Name | BEAU BAUMANN (ADMINISTRATOR) |
| Authorized Official Telephone | 5056233311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH00001203 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 56473 | 05 | |
| OTHER ID NUMBER | 3200540 | 01 |
| Street Address |
111 W HOBBS ST |
| City | ROSWELL |
| State | NM |
| Zip Code | 88203-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093778839 | Jane Marie Gilbreth | Family Medicine | 111 W Hobbs St, Roswell, NM 88203-1869 | 2006-04-11 |
| 1184233132 | Tracy Nicholle Bell | Registered Nurse | 111 W Hobbs St, Roswell, NM 88203-1869 | 2020-07-27 |
| 1528603602 | Amy Lynn Wishard | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2019-11-12 |
| 1093282246 | Rachel M Schupp | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2018-10-25 |
| 1285119651 | Jennifer May | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2018-10-01 |
| 1114445590 | Mark Amba Standley | Physician Assistant | 111 W Hobbs St, Roswell, NM 88203-1869 | 2017-09-06 |
| 1619346376 | Thomas Black | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2015-09-23 |
| 1487688792 | Jo Ann Whiteman | Family Medicine | 111 W Hobbs St, Roswell, NM 88203-1869 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115586 | Katherine Bolin | Behavior Technician | 333 West Brasher Rd. #200, Roswell, NM 88203 | 2020-02-10 |
| 1437660040 | Pecos Valley Eye Surgery Center, LLC | Clinic/Center | 1610 Se Main Street, Roswell, NM 88203 | 2017-10-23 |
| 1285031286 | Wheelchair and Walker Rentals, Inc. | Durable Medical Equipment & Medical Supplies | 305 W Mcgaffey St, Roswell, NM 88203 | 2014-11-20 |
| 1447585914 | Whole World Health Care, PC | Pediatrics | 109 W. Bland, Roswell, NM 88203 | 2009-10-16 |
| 1780825372 | Complete Rehab Adult Services | Clinic/Center | 109 W Bland, Roswell, NM 88203 | 2009-03-12 |
| 1710127220 | Roswell Medical Care | Health Maintenance Organization | 111 W Hobbs, Roswell, NM 88203 | 2009-02-23 |
| 1336330513 | Savitri Aguiar | Internal Medicine | 1511 South Grand, Roswell, NM 88203 | 2007-08-05 |
| 1750455523 | Francisco Casio Bicol Jr. | Occupational Therapist | 200 W 1st St Ste 527, Roswell, NM 88203 | 2006-11-20 |
| 1699861542 | Susan Lee Voigt | Counselor | 200 W 1st, Ste 532, Roswell, NM 88203 | 2006-10-05 |
| 1245336940 | Founders Healthcare LLC | Durable Medical Equipment & Medical Supplies | 104 N Missouri Ave, Roswell, NM 88203 | 2006-09-16 |
| Find all providers in zip 88203 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356835821 | Roswellrx Pharmacy LLC | Pharmacy | 11105 Crabapple Rd, Roswell, GA 30075-2403 | 2018-06-19 |
| 1750410536 | United Supermarkets LLC | Pharmacy | 900 W 2nd St, Roswell, NM 88201-3006 | 2007-03-05 |
| 1982708806 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 12070 Crabapple Rd, Roswell, GA 30075-2422 | 2006-09-12 |
| 1215031158 | Georgia Cvs Pharmacy, L.L.C. | Pharmacy | 895 Holcomb Bridge Rd, Roswell, GA 30076-1954 | 2006-09-12 |
| 1801801709 | Walgreen Co | Pharmacy | 1835 N Main St, Roswell, NM 88201-5168 | 2006-07-29 |
| 1114932316 | Walgreen Co | Pharmacy | 695 W Crossville Rd, Roswell, GA 30075-2500 | 2006-07-29 |
| 1598386351 | Katherine Mackenzie Wood Wimbley | Pharmacy | 791 Atlanta St, Roswell, GA 30075-4452 | 2020-05-04 |
| 1861975088 | Cvs Pharmacy Inc | Pharmacy | 700 N Union Ave, Roswell, NM 88201-3956 | 2018-09-13 |
| 1528558186 | Masoud Khorsand- Sahbaie Md P A | Pharmacy | 400 Military Heights Pl, Roswell, NM 88201-6407 | 2018-05-18 |
| 1558802207 | Miles Connect LLC | Pharmacy | 1570 Holcomb Bridge Rd, Suite 200, Roswell, GA 30076-4703 | 2017-03-14 |
| Find all providers in ROSWELL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.