Healthcare Provider Details

I. General information

NPI: 1114744737
Provider Name (Legal Business Name): ANNAJITA ANDERSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNAJITA RUBIO PHARMD

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 NM 344
EDGEWOOD NM
87015-6849
US

IV. Provider business mailing address

2900 VISTA DEL REY NE UNIT 23C
ALBUQUERQUE NM
87112-8107
US

V. Phone/Fax

Practice location:
  • Phone: 505-286-3053
  • Fax:
Mailing address:
  • Phone: 575-910-6081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010228
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: