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General NPI Number Information
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NPI Number | 1184225070
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Entity Type | Individual
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Provider Name | RUOBING WANG
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Gender | Male
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 1200 S MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88203-5547
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Country | US
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Telephone | 575-624-1439
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Fax | 575-624-0358
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Provider Business Mailing Address
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Address Line | 2602 W RICHEY AVE APT 3201
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City | ARTESIA
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State | NM
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Zip | 88210-9697
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Country | US
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Telephone | 303-775-4603
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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 | 4254
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License Number State | WY
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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 | RP00009392
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License Number State | NM
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