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General NPI Number Information
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NPI Number | 1659735108
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Entity Type | Individual
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Provider Name | ARIKA MIKE
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Gender | Female
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 2401 S 31ST ST MAILSTOP MS-A
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City | TEMPLE
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State | TX
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Zip | 76508-0001
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Country | US
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Telephone | 505-252-0545
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Fax |
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Provider Business Mailing Address
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Address Line | 6220 ESCOVIEL ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2796
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Country | US
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Telephone | 505-252-0545
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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 | 34708
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License Number State | TX
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