Pharmacy On The Bosque LLC
Pharmacy, Compounding Pharmacy in Albuquerque, NM. Organization (NPI-2).
NPI number1538051602
StatusActive
Last updated in NPPESJul 16, 2025
Details
- NPI
- 1538051602
- Entity type
- Organization (NPI-2)
- Legal business name
- Pharmacy On The Bosque LLC
- Organization subpart
- No
- Enumeration date
- Jul 15, 2025
- Certification date
- Jul 16, 2025
- Last updated
- Jul 16, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0004X | Pharmacy, Compounding Pharmacy | – | – | Yes |
Other names
- Pharmacy On The Bosque (Doing Business As)
Practice location
6341 Riverside Plaza Ln Nw Ste BAlbuquerque, NM 87120-2646
Phone 505-546-9217
Mailing address
6341 Riverside Plaza Ln Nw Ste BAlbuquerque, NM 87120-2646
Phone 505-546-9217
Authorized official
Jabari Omar Farrar
Owner
5055469217
Is something wrong?
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All 5 Compounding Pharmacy providers in Albuquerque · All 29,333 providers in Albuquerque
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