Provider Demographics
NPI:1194132274
Name:MARTINEZ, RAMON (RPH, PHARM D)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7389 VISTA DE SOBRE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-0775
Mailing Address - Country:US
Mailing Address - Phone:915-873-1340
Mailing Address - Fax:
Practice Address - Street 1:571 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-8449
Practice Address - Country:US
Practice Address - Phone:575-524-3501
Practice Address - Fax:575-524-0066
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP6940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist