Individual
CHARLES NMI VANDIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH., PH.C.
Contact information
Practice address
1422 PASEO DE PERALTA, SANTA FE, NM 87501-4391
(505) 289-3291
(505) 289-3648
Mailing address
PO BOX 307, 11 PRESTON TRAIL, ANGEL FIRE, NM 87710-0307
(505) 377-2548
(505) 377-2548
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PC00000033
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4458
REGISTERED PHARMACIST #
NM
01
—
CS00021140
NM CONTROLLED SUBST. NUM
NM
01
—
PC00000033
PHARMACIST CLINICIAN NUM
NM
Enumeration date
07/13/2006
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us