Marjorie Hogue
Individual provider Active NPI Pharmacist · Mescalero, NM
NPI 1487030755 · NPPES record last updated Aug 10, 2015
Key facts
- NPI
- 1487030755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11290 (CO)
- Practice address
- 308 Abalone Loop
Mescalero, NM 88340 - Phone
- (575) 464-4441
- NPI assigned
- Aug 10, 2015
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11290 | CO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11290 | CO | Yes |
| Geriatric Pharmacist | 1835G0303X | 11290 | CO | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 11290 | CO | |
| Pharmacotherapy Pharmacist | 1835P1200X | 11290 | CO | |
| Psychiatric Pharmacist | 1835P1300X | 11290 | CO |
Addresses
Primary practice location
308 Abalone Loop
Mescalero, NM 88340
Mailing address
308 Abalone Loop
Mescalero, NM 88340
Phone (575) 464-4441
Other providers in Mescalero, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2015. 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.