Healthcare Provider Details

I. General information

NPI: 1578410833
Provider Name (Legal Business Name): RESIST RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2026
Last Update Date: 03/14/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1382
US

IV. Provider business mailing address

222 CAMINO DE LA TIERRA
CORRALES NM
87048-8562
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-6337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: EFREN GALLARDO
Title or Position: ADMINISTRATOR
Credential: MSW
Phone: 505-226-6337