MEDICARE: LOUIS T ASANGA 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
1	183500000X	Pharmacist	RP00009359	NM

General Provider Information

NPI Number	:	1538761044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS T ASANGA RPH

Provider Business Mailing Address
First Line	:	2351 MAIN ST SE
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-6320
Country	:	US
Telephone Number	:	505-886-2089
Fax Number	:

Provider Business Practice Location Address
First Line	:	2351 MAIN ST SE
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-6320
Country	:	US
Telephone Number	:	505-865-2089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	03/29/2025

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