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NPI Code Detail

MEDICARE: MARTIN S MIERA RPH

MEDICARE: MARTIN S MIERA 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
11835P1200XPharmacotherapy PharmacistRP00004449NM

General Provider Information

NPI Number : 1881827335
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN S MIERA RPH
Provider Business Mailing Address
First Line : 765 CREED AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-1264
Country : US
Telephone Number : 575-640-8650
Fax Number : 575-525-0166
Provider Business Practice Location Address
First Line : 3100 N MAIN ST
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-1162
Country : US
Telephone Number : 575-525-0298
Fax Number : 575-525-0166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2009
Last Update Date : 09/01/2009

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Directions to “ MARTIN S MIERA RPH” Practice Location

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