MEDICARE: MRS. CAROLYN DELICA ABANTE 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
1	183500000X	Pharmacist	RP00007301	NM

General Provider Information

NPI Number	:	1952668477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLYN DELICA ABANTE RPH

Provider Business Mailing Address
First Line	:	600 N GUADALUPE ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1456
Country	:	US
Telephone Number	:	505-982-4806
Fax Number	:	505-982-5138

Provider Business Practice Location Address
First Line	:	600 N GUADALUPE ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87501-1456
Country	:	US
Telephone Number	:	505-982-4806
Fax Number	:	505-982-5138

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

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	04/20/2012

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