Healthcare Provider Details

I. General information

NPI: 1346107653
Provider Name (Legal Business Name): HARRISON DANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MARTIN LUTHER KING AVE NE
ALBUQUERQUE NM
87102-3619
US

IV. Provider business mailing address

3316 WYOMING BLVD NE APT 102
ALBUQUERQUE NM
87111-4401
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010420
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: