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NPI Code Detail

MEDICARE: ROBERTA LEE READ PHARMD

MEDICARE: ROBERTA LEE READ 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
1183500000XPharmacistRP00006308NM

General Provider Information

NPI Number : 1639359102
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERTA LEE READ PHARMD
Provider Business Mailing Address
First Line : 620 MILLS AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4671
Country : US
Telephone Number : 505-425-3317
Fax Number : 505-425-3348
Provider Business Practice Location Address
First Line : 620 MILLS AVE
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4671
Country : US
Telephone Number : 505-425-3317
Fax Number : 505-425-3348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2007
Last Update Date : 11/13/2007

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