Healthcare Provider Details

I. General information

NPI: 1225258734
Provider Name (Legal Business Name): CHAD ANDREW RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 GOLF COURSE RD NW
ALBUQUERQUE NM
87120-5801
US

IV. Provider business mailing address

8301 GOLF COURSE RD NW
ALBUQUERQUE NM
87120-5801
US

V. Phone/Fax

Practice location:
  • Phone: 505-897-1321
  • Fax: 505-897-1013
Mailing address:
  • Phone: 505-897-1321
  • Fax: 505-897-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS010256
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP00006188
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: