Healthcare Provider Details

I. General information

NPI: 1174748727
Provider Name (Legal Business Name): HELEN J. WELDON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2B STATE ROAD 344
EDGEWOOD NM
87015-6849
US

IV. Provider business mailing address

21 NORTH TRL
EDGEWOOD NM
87015-9795
US

V. Phone/Fax

Practice location:
  • Phone: 505-286-9040
  • Fax:
Mailing address:
  • Phone: 505-286-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5860
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: