Healthcare Provider Details

I. General information

NPI: 1760207542
Provider Name (Legal Business Name): XOCHITL BENITEZ PHARMD, PHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4119 WHITE SAGE ARC
LAS CRUCES NM
88011-7326
US

IV. Provider business mailing address

4119 WHITE SAGE ARC
LAS CRUCES NM
88011-7326
US

V. Phone/Fax

Practice location:
  • Phone: 575-323-2093
  • Fax: 575-323-2095
Mailing address:
  • Phone: 575-323-2093
  • Fax: 575-323-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPC00000524
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: