Provider Demographics
NPI:1114744737
Name:RUBIO, ANNAJITA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNAJITA
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 VISTA DEL REY NE UNIT 23C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-8107
Mailing Address - Country:US
Mailing Address - Phone:575-910-6081
Mailing Address - Fax:
Practice Address - Street 1:66 NM 344
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-6849
Practice Address - Country:US
Practice Address - Phone:505-286-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist