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Contact Information

VIDA PHARMACY LLC
8500 JEFFERSON ST NE
STE D
ALBUQUERQUE, NM87113-1883
 Phone: 505-856-1660
 Fax: 505-856-7141
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

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 VIDA PHARMACY LLC

NPI Number 1609056035
LBN Legal business name VIDA PHARMACY LLC
Authorized official ANNABEL ROBERTS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/14/2007
Last updated 12/03/2020 - About 6 years ago
Identifiers
NM License # PH00002980
Other 2059025 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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