| Olive Tree Compounding Pharmacy | |
|
1920 Westside Blvd Se Ste B Rio Rancho NM 87124-4893 | |
| (505) 738-3328 | |
| Not Available |
| Full Name | Olive Tree Compounding Pharmacy |
|---|---|
| Speciality | Clinic/center |
| Location | 1920 Westside Blvd Se Ste B, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Ndidiamaka Okpareke (PRESIDENT AND OWNER) |
| Authorized Official Contact | 7065091012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Tree Compounding Pharmacy 1920 Westside Blvd Se Ste B Rio Rancho NM 87124-4893 Ph: (505) 738-3328 | Olive Tree Compounding Pharmacy 1920 Westside Blvd Se Ste B Rio Rancho NM 87124-4893 Ph: (505) 738-3328 |
| NPI Number | 1053850784 |
|---|---|
| Provider Enumeration Date | 02/14/2017 |
| Last Update Date | 02/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053850784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | PH00004369 (New Mexico) | Primary |
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