Individual
BERNIE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9500 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-4270
(505) 897-7733
Mailing address
9500 GOLF COURSE RD NW, ALBUQUERQUE, NM 87114-4270
(505) 897-7733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00004714
NM
Other
Enumeration date
08/13/2009
Last updated
08/14/2009
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