Healthcare Provider Details

I. General information

NPI: 1134600976
Provider Name (Legal Business Name): JOAQUIN ACOSTA PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 S MAIN ST
LAS CRUCES NM
88001-1290
US

IV. Provider business mailing address

1000 ROBERT RD
GRANTS NM
87020-4012
US

V. Phone/Fax

Practice location:
  • Phone: 575-993-5243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008959
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: