MEDICARE: DR. ANNABEL ROBERTS PHARM.D.

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	1835G0303X	Geriatric Pharmacist	RP00005561	NM

General Provider Information

NPI Number	:	1811592009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNABEL ROBERTS PHARM.D.

Provider Business Mailing Address
First Line	:	8500 JEFFERSON ST NE STE D
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1884
Country	:	US
Telephone Number	:	505-856-1660
Fax Number	:	505-856-7141

Provider Business Practice Location Address
First Line	:	8500 JEFFERSON ST NE STE D
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-1884
Country	:	US
Telephone Number	:	505-856-1660
Fax Number	:	505-856-7141

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

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/03/2020

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