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PORTALES PROFESSIONAL COMPOUNDING LLC
NPI 1679891238
Pharmacy - Compounding Pharmacy in Portales, NM

Active since May 06, 2010
1719 S. AVE D, PORTALES, NM 88130(575) 356-8433 Get Directions Write a Review

NPPES record last updated: May 6, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Portales Professional Compounding Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORTALES PROFESSIONAL COMPOUNDING LLC (NPI 1679891238) is a healthcare organization registered as a compounding pharmacy in Portales, New Mexico and active in the NPI registry since May 2010. The organization lists Alfred Victor Baca, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1679891238
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NamePORTALES PROFESSIONAL COMPOUNDING LLC
Location Address1719 S. AVE DPortales, NM 88130
Mailing Address1719 S. Ave DPortales, NM 88130 · (575) 356-8433
Phone(575) 356-8433
Organization SubpartNo
Authorized OfficialAlfred Victor BacaPharmacist · (575) 356-6068
Enumeration DateMay 6, 2010
✔ NPI 1679891238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in NM · PH00002491
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
1719 S. AVE D, Portales, NM 88130
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portales Professional Compounding LLC's NPI number?

The NPI number for Portales Professional Compounding LLC is 1679891238. It was assigned to this organization in the NPPES registry on May 6, 2010.

Where is Portales Professional Compounding LLC located?

Portales Professional Compounding LLC is located at 1719 S. Ave D, Portales, NM 88130. The listed phone number is (575) 356-8433.

What is Portales Professional Compounding LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

When was this NPI record last updated?

The NPPES record for Portales Professional Compounding LLC was last updated on May 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.