Healthcare Provider Details

I. General information

NPI: 1902320112
Provider Name (Legal Business Name): RICHARD AARON ROBERTS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26180 US HIGHWAY 70
RUIDOSO DOWNS NM
88346-9158
US

IV. Provider business mailing address

26180 US HIGHWAY 70
RUIDOSO DOWNS NM
88346-9158
US

V. Phone/Fax

Practice location:
  • Phone: 575-378-5400
  • Fax: 575-378-5267
Mailing address:
  • Phone: 575-378-5400
  • Fax: 575-378-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4366
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: