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NPI Code Detail

MEDICARE: BETH ANN CHAVEZ RPH

MEDICARE: BETH ANN CHAVEZ RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5319NM

General Provider Information

NPI Number : 1386977676
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH ANN CHAVEZ RPH
Provider Business Mailing Address
First Line : 1425 SAN CARLOS RD SW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87104-1040
Country : US
Telephone Number : 505-843-6334
Fax Number :
Provider Business Practice Location Address
First Line : 3400 COORS BLVD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1448
Country : US
Telephone Number : 505-836-4111
Fax Number : 505-836-9629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 09/17/2009

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