Healthcare Provider Details

I. General information

NPI: 1235462250
Provider Name (Legal Business Name): PAMELA KAY LIMKE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12112 SUMMER WIND PL NE
ALBUQUERQUE NM
87122
US

IV. Provider business mailing address

12112 SUMMERWIND PL NE
ALBUQUERQUE NM
87122-4327
US

V. Phone/Fax

Practice location:
  • Phone: 505-797-7529
  • Fax:
Mailing address:
  • Phone: 505-797-7529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP6542
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: