Healthcare Provider Details

I. General information

NPI: 1710852769
Provider Name (Legal Business Name): LOUIS ALFONCE ADAOAG LEONEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 EUBANK BLVD NE STE A1
ALBUQUERQUE NM
87111-6132
US

IV. Provider business mailing address

5850 EUBANK BLVD NE STE A1
ALBUQUERQUE NM
87111-6132
US

V. Phone/Fax

Practice location:
  • Phone: 505-217-2818
  • Fax:
Mailing address:
  • Phone: 505-217-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010400
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: