Provider Demographics
NPI:1295618791
Name:MESILLA VALLEY PHARMACY & CONSULTING PC
Entity type:Organization
Organization Name:MESILLA VALLEY PHARMACY & CONSULTING PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:575-323-2093
Mailing Address - Street 1:4119 WHITE SAGE ARC STE F
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-7326
Mailing Address - Country:US
Mailing Address - Phone:575-323-2093
Mailing Address - Fax:
Practice Address - Street 1:4119 WHITE SAGE ARC STE F
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7326
Practice Address - Country:US
Practice Address - Phone:575-323-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MESILLA VALLEY PHARMACY & CONSULTING PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-30
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0002XSuppliersPharmacyClinic PharmacyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty