Provider Demographics
NPI:1588058929
Name:THE UNIVERSITY OF NEW MEXICO COLLEGE OF PHARMACY
Entity type:Organization
Organization Name:THE UNIVERSITY OF NEW MEXICO COLLEGE OF PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DEAN FOR CLINICAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:505-272-0983
Mailing Address - Street 1:1650 UNIVERSITY BLVD NE
Mailing Address - Street 2:SUITE 4200
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1726
Mailing Address - Country:US
Mailing Address - Phone:505-272-2281
Mailing Address - Fax:
Practice Address - Street 1:1650 UNIVERSITY BLVD NE
Practice Address - Street 2:SUITE 4200
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1726
Practice Address - Country:US
Practice Address - Phone:505-272-2281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty