Healthcare Provider Details

I. General information

NPI: 1720892516
Provider Name (Legal Business Name): AMY BICKEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 505-506-0669
  • Fax: 505-727-9222
Mailing address:
  • Phone: 505-727-5074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberRP00008947
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: