Mike Lee Gallegos, PHC
Individual provider Active NPI Pharmacist · Placitas, NM
NPI 1003000746 · NPPES record last updated Aug 2, 2021
Key facts
- NPI
- 1003000746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6838 (NM)
- Practice address
- 221 State Highway 165
A-4
Placitas, NM 87043 - Phone
- (505) 867-0733
- Fax
- (505) 785-0886
- NPI assigned
- Sep 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6838 | NM | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6838 | NM | Yes |
Addresses
Primary practice location
221 State Highway 165
A-4
Placitas, NM 87043
Mailing address
221 State Highway 165
A-4
Placitas, NM 87043
Phone (505) 867-0733
Other providers in Placitas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.