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Contact Information

NOWELL PHARMACY LLC
122 W ADAMS AVE
LOVINGTON, NM88260-4010
 Phone: 575-396-4242
 Fax: 575-396-3133
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for NOWELL PHARMACY LLC

NPI Number 1568473114
LBN Legal business name NOWELL PHARMACY LLC
Authorized official JENNA DOMZALSKI DE RIOS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/10/2006
Last updated 09/18/2017 - About 9 years ago
Identifiers
NM License # PH00001233
NM Medicaid 56630
Other 2056596 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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