MEDICARE: DAVID B DENOYER R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	6277	NM

General Provider Information

NPI Number	:	1346422458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID B DENOYER R.PH.

Provider Business Mailing Address
First Line	:	7417 STAGHORN DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-3019
Country	:	US
Telephone Number	:	505-792-9276
Fax Number	:

Provider Business Practice Location Address
First Line	:	7417 STAGHORN DR NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-3019
Country	:	US
Telephone Number	:	505-792-9276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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