Healthcare Provider Details

I. General information

NPI: 1083843205
Provider Name (Legal Business Name): C. NORMAN FINCH JR. PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 E MAIN ST
FARMINGTON NM
87402-7622
US

IV. Provider business mailing address

19 ROAD 6763
FRUITLAND NM
87416-8102
US

V. Phone/Fax

Practice location:
  • Phone: 505-327-0236
  • Fax:
Mailing address:
  • Phone: 505-801-0825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00006469
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: