Active NPI
Chris H Woodul, RPH
- Pharmacist
- Ruidoso, NM
National Provider Identifier
1205020880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5446
- Practice address
- 138 Sudderth Dr
Ruidoso, NM 88345-6025 - Phone
- (505) 257-1566
- Fax
- (505) 257-4600
- NPI assigned
- Aug 28, 2007
- Last updated
- Nov 21, 2013
- 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 | 5446 | NM | Primary |
Addresses
Primary practice location
138 Sudderth Dr
Ruidoso, NM 88345-6025
Mailing address
204 Snowcap Dr
Ruidoso, NM 88345-5604
Phone (505) 258-2819
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5446 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sierra Blanca Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sierra Blanca Pharmacy
- Community/Retail Pharmacy
- Ruidoso, NM
- NPI 1740549054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1205020880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 SNOWCAP DR",
"city": "RUIDOSO",
"state": "NM",
"postal_code": "883455604",
"telephone_number": "505-258-2819",
"fax_number": "505-257-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 SUDDERTH DR",
"city": "RUIDOSO",
"state": "NM",
"postal_code": "883456025",
"telephone_number": "505-257-1566",
"fax_number": "505-257-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODUL",
"first_name": "CHRIS",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "5446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruidoso, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.