Active NPI
Raul Valenzuela, PHARMD
- Pharmacist
- Fort Huachuca, AZ
National Provider Identifier
1093041972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S011587
- Practice address
- USA Meddac, Rwbahc
2240 Winrow Ave
Fort Huachuca, AZ 85613 - Phone
- (520) 533-8718
- NPI assigned
- Oct 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S011587 | AZ | Primary |
Addresses
Primary practice location
USA Meddac, Rwbahc
2240 Winrow Ave
Fort Huachuca, AZ 85613
Mailing address
1178 Sunflower Way
Sierra Vista, AZ 85635-5533
Phone (520) 803-9649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S011587 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1093041972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1178 SUNFLOWER WAY",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856355533",
"telephone_number": "520-803-9649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USA MEDDAC, RWBAHC",
"address_2": "2240 WINROW AVE",
"city": "FORT HUACHUCA",
"state": "AZ",
"postal_code": "85613",
"telephone_number": "520-533-8718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENZUELA",
"first_name": "RAUL",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-27",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S011587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Huachuca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.