Healthcare Provider Details

I. General information

NPI: 1235582248
Provider Name (Legal Business Name): PAULA POPE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2016
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 S CANAL ST
CARLSBAD NM
88220-6523
US

IV. Provider business mailing address

2401 S CANAL ST
CARLSBAD NM
88220-6523
US

V. Phone/Fax

Practice location:
  • Phone: 575-885-1029
  • Fax:
Mailing address:
  • Phone: 575-885-1029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number4566
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: