MEDICARE: CARLA CUYLEAR 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	183500000X	Pharmacist	RP00008029	NM

General Provider Information

NPI Number	:	1578985487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA CUYLEAR R.PH.

Provider Business Mailing Address
First Line	:	241 CARDENAS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-1709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4208 CENTRAL AVE SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-1646
Country	:	US
Telephone Number	:	505-836-6511
Fax Number	:

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

Provider Enumeration Date	:	01/11/2014
Last Update Date	:	01/11/2014

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Directions to “ CARLA CUYLEAR R.PH.” Practice Location

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