MEDICARE: DR. JOHNNY RAY JOSEPH GARCIA 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
1	183500000X	Pharmacist	RP006875	NM

General Provider Information

NPI Number	:	1841351939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNNY RAY JOSEPH GARCIA PHARMD

Provider Business Mailing Address
First Line	:	PO BOX 65997
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87193-5997
Country	:	US
Telephone Number	:	505-610-8110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4580 PARADISE BLVD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-4105
Country	:	US
Telephone Number	:	505-515-2040
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	08/16/2013

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