Individual
MR. MARK LARRAGOITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2801 EUBANK BLVD NE STE A, ALBUQUERQUE, NM 87112-1300
(505) 294-1597
(505) 275-0340
Mailing address
9409 OAKMONT RD NE, ALBUQUERQUE, NM 87111-5822
(505) 857-9252
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00004609
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP00004609
RPH LICENSE-PROVIDER ID
NM
Enumeration date
04/17/2007
Last updated
07/08/2007
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