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General NPI Number Information
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NPI Number | 1023434974
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Entity Type | Individual
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Provider Name | DAVID VARGAS
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Gender | Male
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 1501 SAN PEDRO DR SE NMVAHCS-PHARMACY SERVICE (119)
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5153
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Country | US
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Telephone | 505-265-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 SAN PEDRO DR SE NMVAHCS-PHARMACY SERVICE (119)
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5153
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P6686
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S019688
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | CS19213
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License Number State | ID
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