Healthcare Provider Details

I. General information

NPI: 1659661098
Provider Name (Legal Business Name): JOY PREISSER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2011
Last Update Date: 04/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W HIGHWAY 70
RUIDOSO DOWNS NM
88346-9500
US

IV. Provider business mailing address

648 W MONTEREY AVE
STOCKTON CA
95204-4341
US

V. Phone/Fax

Practice location:
  • Phone: 575-378-5400
  • Fax:
Mailing address:
  • Phone: 209-518-5568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7497
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15654
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: