WELLBORN PHARMACY INC NPI 1720140569

NPI Information

  • NPI: 1720140569
  • Provider Name: WELLBORN PHARMACY, INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Doing Business As: MESA WINDS HEALTHMART PHARMACY
  • Address: 1923 S 1ST ST
    TUCUMCARI, NM
    ZIP 88401
  • Phone: (575) 461-2784

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NPI Details

WELLBORN PHARMACY, INC is a community/retail pharmacy pharmacy in Tucumcari, NM. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. WELLBORN PHARMACY, INC NPI is 1720140569. The provider is registered as an organization entity type.
The provider Is Doing Business As Mesa Winds Healthmart Pharmacy.

The provider's business location address is:

1923 S 1ST ST
TUCUMCARI, NM
ZIP 88401-826
Phone: (575) 461-2784
Fax: (575) 461-2994

The provider's authorized official is Brian Wilson .
The authorized official title is Owner / President and has the following contact phone number (575) 461-2784.

The enumeration date for this NPI number is 12/15/2006 and was last updated on 7/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPH00003107NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12122816OTHERPK
256903MEDICAIDNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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