Alexandra Podosek

Individual provider Active NPI Pharmacist · Crownpoint, NM

NPI 1770139040 · NPPES record last updated Aug 13, 2019

Key facts

NPI
1770139040
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
P8450 (ID)
Practice address
Junction of Highway 371 and Route 9
Crownpoint, NM 87313
Phone
(505) 786-6344
NPI assigned
Aug 13, 2019
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

LicenseStateTypeSpecialty
P8450IDMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P8450 ID Yes

Addresses

Primary practice location

Junction of Highway 371 and Route 9
Crownpoint, NM 87313

Mailing address

PO Box 1688
Crownpoint, NM 87313-1688

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Pharmacist in New Mexico

Sources for this page

Verify at the official NPI Registry.