1629298880 NPI number — SAMUEL K CHOY R.PH

Table of content: SAMUEL K CHOY R.PH (NPI 1629298880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629298880 NPI number — SAMUEL K CHOY R.PH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOY
Provider First Name:
SAMUEL
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.PH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629298880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7120 WYOMING BLVD NE
Provider Second Line Business Mailing Address:
7B
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87109-4887
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-346-0533
Provider Business Mailing Address Fax Number:
505-346-0532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7120 WYOMING NE
Provider Second Line Business Practice Location Address:
SUITE 7B
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-4887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-346-0533
Provider Business Practice Location Address Fax Number:
505-346-0532
Provider Enumeration Date:
04/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  00004023 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RP00004023 . This is a "PHARMACIST LICENSE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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