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NPI Code Detail

MEDICARE: MRS. CHRISTINE E. MARTINEZ-VIGIL PHC,RPH

MEDICARE: MRS. CHRISTINE E. MARTINEZ-VIGIL PHC,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
1183500000XPharmacistRP00005496NM
2183500000XPharmacistPC00000038NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780677153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE E. MARTINEZ-VIGIL PHC,RPH
Provider Business Mailing Address
First Line : 538 N PASEO DE ONATE
Second Line : P.O. BOX 158
City : ESPANOLA
State : NM
Zip : 87532-2618
Country : US
Telephone Number : 505-753-7218
Fax Number : 505-753-5815
Provider Business Practice Location Address
First Line : 2010 INDUSTRIAL PARK RD
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-3600
Country : US
Telephone Number : 505-753-7218
Fax Number : 505-753-5815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/09/2013

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Directions to “ MRS. CHRISTINE E. MARTINEZ-VIGIL PHC,RPH” Practice Location

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