Individual
JEREMY MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8011 HARPER DR NE, ALBUQUERQUE, NM 87111-1054
(505) 858-3134
Mailing address
1412 MONTIANO LOOP SE, RIO RANCHO, NM 87124-8770
(505) 507-4094
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008771
NM
Other
Enumeration date
08/04/2017
Last updated
08/04/2017
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