Healthcare Provider Details

I. General information

NPI: 1043445448
Provider Name (Legal Business Name): PARAG ANANT PARANJAPE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 COORS BLVD NW
ALBUQUERQUE NM
87120-2785
US

IV. Provider business mailing address

2021 VIOLETA WAY SE
RIO RANCHO NM
87124-4039
US

V. Phone/Fax

Practice location:
  • Phone: 505-898-5970
  • Fax:
Mailing address:
  • Phone: 505-792-6134
  • Fax: 505-990-6841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007168
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: