John Robert Alvis, R.PH.
Individual provider Active NPI Pharmacist · Edgewood, NM
NPI 1275935793 · NPPES record last updated Sep 16, 2014
Key facts
- NPI
- 1275935793
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP00004758 (NM)
- Practice address
- 66 State Road 344
Edgewood, NM 87015-6849 - Phone
- (505) 286-3053
- Fax
- (505) 286-3055
- NPI assigned
- Sep 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00004758 | NM | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00004758 | NM | Yes |
Addresses
Primary practice location
66 State Road 344
Edgewood, NM 87015-6849
Mailing address
66 State Road 344
Edgewood, NM 87015-6849
Phone (505) 286-3053
Other providers in Edgewood, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 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.