Individual
MR. TRACY WILLIAM FORWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
9640 MENAUL BLVD NE, ALBUQUERQUE, NM 87112-2217
(505) 294-4167
(505) 294-5229
Mailing address
1 CASA LOMA RD, CEDAR CREST, NM 87008-9435
(505) 239-4930
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006450
NM
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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