Healthcare Provider Details

I. General information

NPI: 1922426295
Provider Name (Legal Business Name): TAMELA SZALOY R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 ENCINO PL NE
ALBUQUERQUE NM
87102-2611
US

IV. Provider business mailing address

717 ENCINO PL NE
ALBUQUERQUE NM
87102-2611
US

V. Phone/Fax

Practice location:
  • Phone: 505-243-3777
  • Fax: 505-246-0145
Mailing address:
  • Phone: 505-243-3777
  • Fax: 505-246-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5216
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: