Individual
PERRY PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
13251 CHACO CANYON LN NE, ALBUQUERQUE, NM 87111-7117
(505) 821-5165
Mailing address
13251 CHACO CANYON LN NE, ALBUQUERQUE, NM 87111-7117
(505) 821-5165
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00010684
WA
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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