Healthcare Provider Details

I. General information

NPI: 1336749282
Provider Name (Legal Business Name): MARCUS A GARCIA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 EUBANK BLVD SE
ALBUQUERQUE NM
87123-3338
US

IV. Provider business mailing address

500 EUBANK BLVD SE
ALBUQUERQUE NM
87123-3338
US

V. Phone/Fax

Practice location:
  • Phone: 505-332-6602
  • Fax:
Mailing address:
  • Phone: 505-332-6602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00009411
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: