Renee Allison
Individual provider Active NPI Pharmacist · Las Cruces, NM
NPI 1003215112 · NPPES record last updated Aug 14, 2014
Key facts
- NPI
- 1003215112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5695 (NM)
- Practice address
- 3331 Rinconada Blvd
Las Cruces, NM 88011-7193 - Phone
- (575) 680-3779
- NPI assigned
- Aug 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 5695 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5695 | NM | Yes |
Addresses
Primary practice location
3331 Rinconada Blvd
Las Cruces, NM 88011-7193
Mailing address
3331 Rinconada Blvd
Las Cruces, NM 88011
Phone (575) 680-3779
Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2014. 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.