Healthcare Provider Details

I. General information

NPI: 1942596309
Provider Name (Legal Business Name): VICTORIA BETH ROJO R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 WYOMING BLVD NE
ALBUQUERQUE NM
87113-1946
US

IV. Provider business mailing address

7404 EL MORRO RD NE
ALBUQUERQUE NM
87109-3804
US

V. Phone/Fax

Practice location:
  • Phone: 505-857-9783
  • Fax: 505-857-9783
Mailing address:
  • Phone: 505-899-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00006087
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: