Individual
ANDREW PORTILLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
338 OSUNA RD NW, LOS RANCHOS, NM 87107-6125
(505) 345-3568
(505) 345-1542
Mailing address
338 OSUNA RD NW, LOS RANCHOS, NM 87107-6125
(505) 345-3568
(505) 345-1542
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3822
NM
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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