Healthcare Provider Details

I. General information

NPI: 1891044319
Provider Name (Legal Business Name): TRACEY A JAGLOWITZ PHARMD, RPH, PHC, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. TRACEY A BARBERI

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 12/22/2023
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 N TELSHOR BLVD
LAS CRUCES NM
88011-8202
US

IV. Provider business mailing address

7356 VISTA DE SOBRE DR
LAS CRUCES NM
88012-0714
US

V. Phone/Fax

Practice location:
  • Phone: 575-521-7890
  • Fax:
Mailing address:
  • Phone: 505-554-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007713
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPC00000313
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: