Healthcare Provider Details

I. General information

NPI: 1164831202
Provider Name (Legal Business Name): CHRISTOPHER JAMES MARTINEZ PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2014
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1306
US

IV. Provider business mailing address

4950 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1306
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-8706
  • Fax: 505-830-0411
Mailing address:
  • Phone: 505-883-8706
  • Fax: 505-830-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008104
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0020789
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: