Healthcare Provider Details

I. General information

NPI: 1184930489
Provider Name (Legal Business Name): BRITTANY IRWIN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 S SAINT FRANCIS DR
SANTA FE NM
87505-1654
US

IV. Provider business mailing address

1096 S SAINT FRANCIS DR
SANTA FE NM
87505-1654
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-9811
  • Fax:
Mailing address:
  • Phone: 505-982-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007525
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: