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General NPI Number Information
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NPI Number | 1255714713
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Entity Type | Organization
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Legal Business Name | CVS HEALTH PHARMACY
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 07/02/2015
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Provider Practice Location Address
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Address Line | 7847 TRAMWAY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2515
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Country | US
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Telephone | 505-821-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 MONTE SERRANO NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-1285
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Country | US
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Telephone | 505-314-4933
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. RAYMOND MARTINEZ
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Credential | PHARM. D
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Telephone | 505-314-4933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 183500000X
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License Number State | NM
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