Renu Bala
Individual provider Active NPI Pharmacist · Zuni, NM
NPI 1053876599 · NPPES record last updated Feb 8, 2019
Key facts
- NPI
- 1053876599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202216043 (VA)
- Practice address
- 12 B Ave
Zuni, NM 87327 - Phone
- (505) 782-4431
- NPI assigned
- Feb 8, 2019
- Sex
- Female
- 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 |
|---|---|---|---|
| 0202216043 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202216043 | VA | Yes |
Addresses
Primary practice location
12 B Ave
Zuni, NM 87327
Mailing address
PO Box 978
Zuni, NM 87327-0978
Phone (469) 767-2781
Other providers in Zuni, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2019. 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.