Healthcare Provider Details

I. General information

NPI: 1598914244
Provider Name (Legal Business Name): DON AHRENS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 NIZHONI BLVD
GALLUP NM
87301-5748
US

IV. Provider business mailing address

311 TANNER AVE
GALLUP NM
87301-7109
US

V. Phone/Fax

Practice location:
  • Phone: 505-722-1476
  • Fax: 505-726-8621
Mailing address:
  • Phone: 505-726-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number7088
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: