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NPI Code Detail

MEDICARE: DR. PAMELA WALTON MCCOY PHARMD

MEDICARE:  DR. PAMELA WALTON MCCOY  PHARMD
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
11835P1200XPharmacotherapy PharmacistPS34319FL

General Provider Information

NPI Number : 1619964293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAMELA WALTON MCCOY PHARMD
Provider Business Mailing Address
First Line : 20 BRANDY LN
Second Line :
City : TIJERAS
State : NM
Zip : 87059-8121
Country : US
Telephone Number : 505-286-0134
Fax Number :
Provider Business Practice Location Address
First Line : 1501 SAN PEDRO DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-5153
Country : US
Telephone Number : 505-265-1711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 07/08/2007

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Directions to “ DR. PAMELA WALTON MCCOY PHARMD” Practice Location

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