Healthcare Provider Details

I. General information

NPI: 1215862628
Provider Name (Legal Business Name): RAUL ALEJANDRO SALAZAR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 20TH ST
FARMINGTON NM
87401-2108
US

IV. Provider business mailing address

5327 MONTGOMERY BLVD NE APT 99
ALBUQUERQUE NM
87109-1320
US

V. Phone/Fax

Practice location:
  • Phone: 505-325-1774
  • Fax:
Mailing address:
  • Phone: 505-514-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP00010473
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: