Provider Demographics
NPI:1265305932
Name:EL FARISSE, EL MEHDI (PHARMD)
Entity type:Individual
Prefix:
First Name:EL MEHDI
Middle Name:
Last Name:EL FARISSE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 ENCHANTED HILLS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-8623
Mailing Address - Country:US
Mailing Address - Phone:505-771-8411
Mailing Address - Fax:505-771-9255
Practice Address - Street 1:7800 ENCHANTED HILLS BLVD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-8623
Practice Address - Country:US
Practice Address - Phone:505-771-8411
Practice Address - Fax:505-771-9255
Is Sole Proprietor?:No
Enumeration Date:2025-09-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist