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NPI Code Detail

MEDICARE: MS. ANDREA NICOLE PACHECO RPH

MEDICARE: MS. ANDREA NICOLE PACHECO RPH
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
1183500000XPharmacist6705NM

General Provider Information

NPI Number : 1588847016
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA NICOLE PACHECO RPH
Provider Business Mailing Address
First Line : 3818 JACK NICKLAUS DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-3913
Country : US
Telephone Number : 505-480-7691
Fax Number :
Provider Business Practice Location Address
First Line : 2551 E LOHMAN AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-8233
Country : US
Telephone Number : 505-521-9841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2007
Last Update Date : 12/06/2007

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