Healthcare Provider Details

I. General information

NPI: 1528738804
Provider Name (Legal Business Name): DEBORAH ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 PARADISE BLVD NW
ALBUQUERQUE NM
87114-4105
US

IV. Provider business mailing address

4580 PARADISE BLVD NW
ALBUQUERQUE NM
87114-4105
US

V. Phone/Fax

Practice location:
  • Phone: 505-823-8800
  • Fax:
Mailing address:
  • Phone: 505-823-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: