Healthcare Provider Details

I. General information

NPI: 1467978627
Provider Name (Legal Business Name): STEVEN GATES PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2017
Last Update Date: 10/17/2020
Certification Date: 10/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 MCMAHON BLVD NW
ALBUQUERQUE NM
87114-5010
US

IV. Provider business mailing address

9908 BUCKEYE ST NW
ALBUQUERQUE NM
87114-5206
US

V. Phone/Fax

Practice location:
  • Phone: 505-922-4303
  • Fax:
Mailing address:
  • Phone: 505-720-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP00008729
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: