STATE OF NEW MEXICO (NPI# 1740659150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740659150 |
| Entity Type | Organization |
| Organization Name | STATE OF NEW MEXICO |
| Other Organization Name | FORT BAYARD MEDICAL CENTER PHARMACY |
| Practice Address |
41 Fort Bayard Rd Santa Clara NM 88026 |
| Mailing Address |
Po Box 293 Santa Clara NM 88026-0293 |
| Practice Telephone | 5755378745 |
| Practice Fax Number | 5755378897 |
| Mailing Telephone | 5755378745 |
| Mailing Fax Number | 5755378897 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2018-04-20 |
| Authorized Official Name | WILLIAM DOWLER (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 5755378745 |
| Authorized Official Credential | RPH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PH00004050 | NM | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 58933221 | 05 | |
| PK | 2156121 | 01 |
| Other Name | Type Code |
|---|---|
| Fort Bayard Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457539322 | State of New Mexico | Public Health or Welfare | 2025 S Pacheco St, Santa Fe, NM 87505-3991 | 2008-02-04 |
| 1982730669 | State of New Mexico | Skilled Nursing Facility | 41 Fort Bayard Road, Santa Clara, NM 88026 | 2007-02-26 |
| 1578609459 | State of New Mexico | Public Health or Welfare | 605 Letrado, Santa Fe, NM 87505 | 2007-01-29 |
| 1508914896 | State of New Mexico | Case Management | 2040 S Pacheco St, Santa Fe, NM 87505-5472 | 2007-01-05 |
| 1942287370 | State of New Mexico | Skilled Nursing Facility | 992 S Broadway, Truth Or Consequences, NM 87901-3198 | 2005-12-28 |
| 1578075016 | State of New Mexico | Special Hospital | 72 Gail Harris St, Roswell, NM 88203-8116 | 2017-10-24 |
| 1518294107 | State of New Mexico | Psychiatric Hospital | 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 | 2009-11-03 |
| 1578730230 | State of New Mexico | Skilled Nursing Facility | 992 S Broadway, Truth Or Consequences, NM 87901-3198 | 2008-05-13 |
| 1972784544 | State of New Mexico | Public Health or Welfare | 605 Letrado, Santa Fe, NM 87505 | 2007-11-23 |
| 1124211404 | State of New Mexico | Social Worker | 3695 Hot Springs Blvd, Las Vegas, NM 87701-9549 | 2007-08-21 |
| Street Address |
41 FORT BAYARD RD |
| City | SANTA CLARA |
| State | NM |
| Zip Code | 88026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568821015 | Fort Bayard Medical Center Department of Health | Skilled Nursing Facility | 41 Fort Bayard Rd, Santa Clara, NM 88026-0293 | 2016-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265666 | Hidalgo Medical Services | Clinic/Center | 105 1/2 N East St., Santa Clara, NM 88026 | 2020-08-12 |
| 1245688647 | Rio Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 405 Manhattan Park Dr, Santa Clara, NM 88026 | 2016-05-26 |
| 1396106670 | Ft Bayard Medical Center Department of Health | Pharmacy | 41 Ft. Bayard Rd., Santa Clara, NM 88026 | 2016-03-14 |
| 1982730669 | State of New Mexico | Skilled Nursing Facility | 41 Fort Bayard Road, Santa Clara, NM 88026 | 2007-02-26 |
| 1871508648 | Luther Dwayne Morris | Chiropractor | 12087 Hwy 180 E., Santa Clara, NM 88026 | 2006-07-30 |
| 1740506369 | Morris Chiropractic Center Pa | Clinic/Center | 12087 Hwy 180 E., Santa Clara, NM 88026-0000 | 2010-04-08 |
| 1033314166 | Samuel Joseph Limon | Occupational Therapist | 606 N. Bayard, Apt #3, Santa Clara, NM 88026-0122 | 2007-06-19 |
| 1912447194 | Angelica Boone | Behavior Technician | 302 S Prescott, Santa Clara, NM 88026-0594 | 2017-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558969337 | Colter Engber | Student in an Organized Health Care Education/Training Program | 3486 Golden State Dr, Santa Clara, CA 95051-4611 | 2020-10-13 |
| 1245837566 | Irshad H Fardan | Contractor | 2167 Pasetta Dr Apt 1, Santa Clara, CA 95050-3249 | 2020-10-09 |
| 1215543491 | Lashanette Jeanean Breazell | Behavior Technician | 50 Washington St Apt 37, Santa Clara, CA 95050-6143 | 2020-09-22 |
| 1104432822 | Kahleah Bynah Dugan | Behavior Technician | 4701 Patrick Henry Dr Bldg 6, Santa Clara, CA 95054-1863 | 2020-09-17 |
| 1972118651 | Christopher Christman | Massage Therapist | 1243 Carmel Way, Santa Clara, CA 95050-5224 | 2020-09-10 |
| 1316552987 | Katherine Tran | Physician Assistant | 3777 Inglewood Dr, Santa Clara, CA 95054-2139 | 2020-09-10 |
| 1376158907 | Madeleine Ma | Physician Assistant | 1825 Civic Center Dr Ste 25, Santa Clara, CA 95050-7302 | 2020-09-10 |
| 1710591979 | Viktor Vasas | Nurse Practitioner | 4501 Carlyle Ct Apt 1308, Santa Clara, CA 95054-3925 | 2020-09-04 |
| 1568074383 | Katelyn Ann Hakinson | Student in an Organized Health Care Education/Training Program | 2173 Calabazas Blvd, Santa Clara, CA 95051-1634 | 2020-08-21 |
| 1760094015 | Hadia Abdelgawad | Registered Nurse | 3001 Pruneridge Ave, Santa Clara, CA 95051-5611 | 2020-08-18 |
| Find all providers in SANTA CLARA | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497938286 | Injun Yu, Youngock Yu | Pharmacy | 1090 Kiely Blvd., A, Santa Clara, CA 95051 | 2007-12-14 |
| 1477590149 | Lucky Stores II LLC | Pharmacy | 3705 El Camino Real, Santa Clara, CA 95051-2614 | 2006-06-01 |
| 1063712057 | Kaiser Foundation Hospitals | Pharmacy | 3840 Homestead Rd, Santa Clara, CA 95051-4542 | 2010-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184264145 | Benzer Nm 1 LLC | Pharmacy | 2000 Carlisle Blvd Ne Ste E, Albuquerque, NM 87110-4973 | 2020-01-08 |
| 1699258947 | Mjrx IIi, LLC | Pharmacy | 151 S Walnut St Ste A5, Las Cruces, NM 88001-2613 | 2018-09-12 |
| 1750803466 | Bobs' Budget Pharmacy | Pharmacy | 511 S 2nd St, Tucumcari, NM 88401-2861 | 2017-07-13 |
| 1326577651 | Bestcare Pharmacy-mora LLC | Pharmacy | #3 A033, Mora, NM 87732 | 2017-06-09 |
| 1831637636 | Bestcare Pharmacy Springer LLC | Pharmacy | 307 Maxwell Ave, #b, Springer, NM 87747 | 2017-02-01 |
| 1427501279 | Walmart Pharmacy | Pharmacy | 1401 E Navajo Dr, Apt 3104, Hobbs, NM 88240-9433 | 2016-07-28 |
| 1063872455 | The Pill Box Pharmacy | Pharmacy | 1010 Bridge Blvd Sw Ste B2, Albuquerque, NM 87105-3765 | 2016-02-29 |
| 1558721043 | Newscripts Pharmacy LLC | Pharmacy | 7103 4th St Nw Ste G, Los Ranchos, NM 87107-6675 | 2016-02-26 |
| 1134596976 | Genoa Healthcare, LLC | Pharmacy | 7850 Jefferson St Ne Ste 301, Albuquerque, NM 87109-4315 | 2015-08-27 |
| 1346623295 | Unm Hospital | Pharmacy | 2211 Lomas Blvd Ne # 4acc, Albuquerque, NM 87106-2719 | 2015-07-09 |
| Find all providers with the same taxonomy | ||||
| City | SANTA CLARA |
| Zip Code | 88026 |
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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.