Sophie Soo, PHARMD
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Crownpoint, NM
NPI 1154979128 · NPPES record last updated Sep 3, 2019
Key facts
- NPI
- 1154979128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- PC00000301 (NM)
- Practice address
- Junction of Highway 371 and Route 9
Crownpoint, NM 87313 - Phone
- (505) 786-6344
- NPI assigned
- Sep 3, 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00009048 | NM | MD | Pharmacist |
| PC00000301 | NM | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 24981 | MD | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00009048 | NM | |
| Pharmacist | 183500000X | 24981 | MD | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PC00000301 | NM | Yes |
Addresses
Primary practice location
Junction of Highway 371 and Route 9
Crownpoint, NM 87313
Mailing address
PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-6344
Other providers in Crownpoint, NM
- Roy Salcido
- Carla J Sand
- Cody Schneider
- Ragheb Senan
- Mavis Smith
- Roger William Studd
- Thoreau Health Station
- Theresa Tolth
- Karen Mai Linh Tong
- Bobbie Lynn Tracy
All providers in Crownpoint, NM · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 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.