Healthcare Provider Details

I. General information

NPI: 1669317343
Provider Name (Legal Business Name): TONYA JARAMILLO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAGEBRUSH ST SW
ALBUQUERQUE NM
87105-3942
US

IV. Provider business mailing address

PO BOX 640
ISLETA NM
87022-0640
US

V. Phone/Fax

Practice location:
  • Phone: 505-869-4474
  • Fax: 505-869-4583
Mailing address:
  • Phone: 505-869-4474
  • Fax: 505-869-4583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008533
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: