MEDICARE: CARRIE SILVA

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	RP00006371	NM

General Provider Information

NPI Number	:	1720395627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE SILVA

Provider Business Mailing Address
First Line	:	1432 ROSALEE RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-3358
Country	:	US
Telephone Number	:	505-440-7549
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 ARENAL RD SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87105-4048
Country	:	US
Telephone Number	:	505-877-4542
Fax Number	:	505-873-5810

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

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	09/13/2010

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Directions to “ CARRIE SILVA ” Practice Location

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