Healthcare Provider Details

I. General information

NPI: 1396225520
Provider Name (Legal Business Name): ROBERT WAYNE HOWARD III PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 EL PASEO RD
LAS CRUCES NM
88001-6000
US

IV. Provider business mailing address

435 ITHACA CT APT H3
LAS CRUCES NM
88011-7071
US

V. Phone/Fax

Practice location:
  • Phone: 575-541-1264
  • Fax: 575-541-1292
Mailing address:
  • Phone: 936-615-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008960
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: