Healthcare Provider Details

I. General information

NPI: 1124437850
Provider Name (Legal Business Name): MARIA MOYA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 10/14/2023
Certification Date: 10/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 UNSER BLVD SE
RIO RANCHO NM
87124-6365
US

IV. Provider business mailing address

5200 CLOVIS CT NE
RIO RANCHO NM
87144-6327
US

V. Phone/Fax

Practice location:
  • Phone: 505-962-9239
  • Fax:
Mailing address:
  • Phone: 505-639-3083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007395
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: