Healthcare Provider Details

I. General information

NPI: 1063427607
Provider Name (Legal Business Name): UNM STUDENT HEALTH CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

I UNIV OF NEW MEXICO MSC06 3870 BLDG 73 RM 206
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

I UNIV OF NEW MEXICO MSC06 3870 BLDG 73 RM 206, MSC06-3870
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 505-277-6306
  • Fax: 505-277-0286
Mailing address:
  • Phone: 505-277-6306
  • Fax: 505-277-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH00002166
License Number StateNM

VIII. Authorized Official

Name: CHRISTIAN HERMOSILLO
Title or Position: PHARMACY MANAGER
Credential:
Phone: 505-277-4469