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General NPI Number Information
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NPI Number | 1043571920
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Entity Type | Individual
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Provider Name | TSEHAYE K ZEMENFES PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | MM 29 OF HIGHWAY 169
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City | ALAMO
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State | NM
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Zip | 87825
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Country | US
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Telephone | 575-854-2610
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Fax | 575-854-2528
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Provider Business Mailing Address
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Address Line | PO BOX 784
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City | MAGDALENA
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State | NM
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Zip | 87825-0784
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Country | US
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Telephone | 202-735-8215
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | RP00008519
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License Number State | NM
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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 | PH100000941
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License Number State | DC
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