Elona Van Wagenen, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP00007292 Issued in NM

Practice address

4800 McMahon Blvd NW
Albuquerque, NM 87114-5010

Phone

(505) 922-4303

Fax

(505) 922-4313

NPI assigned

Sep 21, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1063693943
  NPD (past)
• Smith'S Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1881585248
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1891003067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 MCMAHON BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145010",
            "telephone_number": "505-922-4303",
            "fax_number": "505-922-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MCMAHON BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145010",
            "telephone_number": "505-922-4303",
            "fax_number": "505-922-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WAGENEN",
        "first_name": "ELONA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00007292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilith Van Ry
• Julie K Van Someren, MD
• Melinda Van Stone, D.C.
• Eya Sofia Van Tassle, LMSW
• Rebecca Van Vleck
• Paige Van Wagenen, HIS11
• Viviana Van Wagoner, LPN
• Annika Van Wieren, MD
• Megan Van Winkle, MD
• Dawn Vana

• Pharmacist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pharmacist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.