Healthcare Provider Details

I. General information

NPI: 1336372556
Provider Name (Legal Business Name): MEGHAN ROSS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2009
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MAIN ST NE
LOS LUNAS NM
87031-6340
US

IV. Provider business mailing address

2400 UNSER BLVD SE STE 18008
RIO RANCHO NM
87124-4740
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-7551
  • Fax: 505-865-7018
Mailing address:
  • Phone: 505-253-6015
  • Fax: 505-253-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007169
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: